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Comparison of pseudoexfoliation syndrome and normal cases undergoing manual small-incision cataract surgery in a tertiary health-care center in Eastern India

INTRODUCTION: Pseudoexfoliation (PXF) syndrome has been known to be a genetically inherited syndrome which generally affects the population above 50 years of age. It further increases the chances of complications during cataract surgery. AIM: In our study, we aim to compare the results of manual small-incision cataract surgery (MSICS) in PXF eyes and controls and report the intraoperative and postoperative outcomes (up to 6 weeks) in both groups. MATERIALS AND METHODS: This was a prospective, observational, nonrandomized study, which was conducted in the ophthalmology department in a tertiary hospital in Eastern India from February 1, 2018, to December 31, 2019. 50 patients with PXF (Group 1) and 50 controls (Group 2) were included in this study and assigned to undergo MSICS. RESULTS: Group 1 patients (with PXF) were found to be significantly of older age (P = 0.0315). Mixed cataract, i.e. with cortical and nuclear sclerosis, was present in 22 (44%) eyes in Group 1 and 31 (62%) eyes in Group 2. After attaining maximum dilatation, the 1st group was observed to have significantly smaller mean pupil diameter than 2nd group (P = 0.0001). In Group 1, intraoperative complications were observed: zonular dehiscence in 3 (6%) eyes, posterior capsule tear/rupture in 7 (14%) eyes, and vitreous loss in 6 (12%) eyes (including 3 eyes of zonular dialysis). In the 2nd group, no such complications were encountered during surgery. Postoperatively, anterior chamber cells and flares were significantly more in the 1st group than that in the 2nd group (P = 0.0002). Best-corrected visual acuity of 6/12 or better was found in 43 eyes (86%) of the 1st group and in 46 eyes (92%) of the 2nd group. CONCLUSION: We conclude that with meticulous preoperative evaluation, vigilant intraoperative measures, and proper surgical expertise, MSICS can be an apparently safe procedure in patients with PXF syndrome.