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Abstract #26587 Published in IGR 12-3
Pseudoexfoliation: High risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification
Shingleton BJ; Marvin AC; Heier JS; O'Donoghue MW; Laul A; Wolff B; Rowland AJournal of Cataract and Refractive Surgery 2010; 36: 1261-1269
PURPOSE: To assess the frequency and results of cataract surgery with concurrent vitrectomy due to zonule weakness in eyes with pseudoexfoliation (PXF). SETTING: Private practice, Boston, Massachusetts, USA. METHODS: This retrospective nonrandomized study assessed consecutive eyes with PXF having cataract surgery. High risk was defined as preoperative phacodonesis, iridodonesis, or lens subluxation (subgroup 1); preoperative anterior chamber depth or angle-depth asymmetry between eyes confirmed by slitlamp biomicroscopy or gonioscopy, respectively (subgroup 2); or complicated cataract extraction related to zonule weakness in the fellow eye (subgroup 3). Exclusion criteria were previous vitrectomy, scleral buckle, or trabeculectomy surgery and combined cataract-glaucoma surgery. A comparative analysis of outcome parameters was performed. RESULTS: Of the 1059 eyes evaluated, 38 had vitrectomy. Concurrent vitrectomy was required in 19 (15.6%) of 122 high-risk eyes and 19 (2.0%) of 937 non-high-risk eyes (P<.00001). The need for concurrent vitrectomy was greatest in subgroup 3 (72.7%) and subgroup 1 (42.9%). There was no statistically significant difference between the vitrectomy group and the no-vitrectomy group in the mean improvement in logMAR corrected distance visual acuity (CDVA) (P =.38) or mean change in intraocular pressure (IOP) (mean decrease 2.6 mm Hg (plus or minus) 1.5 [SD] and 1.6 (plus or minus) 0.5 mm Hg, respectively) (P =.47). Conclusion: Despite the need for vitrectomy and the attendant increased demands in postoperative care, both the vitrectomy group and no-vitrectomy group had improved logMAR CDVA and IOP.
B. J. Shingleton. Ophthalmic Consultants of Boston, Center for Eye Research and Education, 50 Staniford Street, Boston, MA 02114, United States. bjshingleton@eyeboston.com
Classification:
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
12.16 Vitrectomy (Part of: 12 Surgical treatment)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
