Cataract Surgery in Eyes with Pseudoexfoliation (PEX) Syndrome

Abstract

Pseudoexfoliation (PEX) syndrome is a common age-related systemic disorder characterized by a huge production and deposition of fibrillogranular amyloid-like extracellular material within many ocular tissues. Pseudoexfoliation is a risk factor for glaucoma and also correlated to an increased incidence of cataract formation. Cataract surgery in eyes with pseudoexfoliation is connected with many complications and presents challenges that require careful preoperative planning and intraoperative care to ensure safe surgery and successful postoperative outcome. Zonular weakness and poor pupillary dilation are two major risk factors for surgical complications and poor visual acuity after surgery. With proper preparation and use of specialized adjunctive devices, phacoemulsification (PHACO) is the preferred procedure of cataract extraction in this group of patients. Postoperatively pseudoexfoliation patients require frequent and detailed follow-up to monitor for complications such as intraocular pressure rise, inflammation and intraocular lens dislocation. In conclusion, with appropriate preoperative, intraoperative and postoperative care the risks of complications can be minimized and favourable outcomes can be achieved in cataract surgery in eyes with pseudoexfoliation syndrome.