Zonular weakness responsible for cataract surgery complications in pseudoexfoliation

Intraoperative complications during cataract surgery in patients with pseudoexfoliaton syndrome is a result of zonular weakness, not capsule tears, according to a large retrospective study.

Bradford Shingleton, MD, and colleagues at Ophthalmic Consultants of Boston reviewed 297 cases of cataract extraction in patients with pseudoexfoliaton syndrome and 427 cases of cataract extraction in patients without the syndrome, to characterize differences in technique, complications and outcomes.

The authors noted that, even at 2 years postoperative, the decline in intraocular pressure was greater for patients with pseudoexfoliation than those without. This led them to suggest a potential for long-term improvement of outflow facility in glaucoma patients who undergo cataract surgery.

They found that no patients without pseudoexfoliation had vitreous loss, but 4% of those with pseudoexfoliation did. The prevalence of hypertension (50%) and diabetes (11%) was significantly greater in patients without pseudoexfoliation than in those with the syndrome.

The study is published in the June issue of Journal of Cataract & Refractive Surgery.