Correlation Of Pupil Diameter And Intraoperative Complications In Patients With Pseudoexfoliation Undergoing Phacoemulsification Cataract Surgery.

General Objective: Determine if the pupil diameter correlates with the incidence of intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification cataract surgery.

Specific Objectives:

1. Measure the preoperative pupil diameter in patients with pseudoexfoliation.
2. Correlate a pupil diameter of less than 5.5 mm with the presence of intraoperative complications in patients with pseudoexfoliation undergoing phacoemulsification surgery.
3. Correlate the surgeon's level of experience with the presence of intraoperative complications in patients with pseudoexfoliation.
4. Determine the incidence of Intraoperative Floppy Iris Syndrome in patients with pseudoexfoliation.
5. Determine the incidence of zonular instability.

Clínica oftalmológica Salauno, Ciudad de México, México.

Design: Prospective, cross-sectional, observational, and descriptive study. The study will collect data from May 2024 to May 2025.

Identification of variables

Preoperative pupil diameter less than 5.5 mm

Preoperative pupil diameter greater than or equal to 5.5 mm 

Surgeon level

• • Senior Plus over 1000 surgeries.
  • "Senior" over 300 surgeries but fewer than 1000.
  • "Intermediate" over 40 surgeries but fewer than 300.

Presence of zonular instability 

Dilation method (TP, iris hooks, stretching)

Surgical step of the complication

Inclusion criteria

• Over 18 years old.
• Sign informed consent.
• Senile cataract and pseudoexfoliation.

Exclusion criteria

• • Previous intraocular surgery.
  • History of ocular trauma.
  • Collagenopathies.
  • Diabetes mellitus.
  • Corneal scars
  • Fixation loss.

The normality of the variables will be assessed using the Shapiro-Wilk test with a significance level of 0.05. Descriptive statistics will be performed, presenting the variables with summary measures of central tendency and dispersion for quantitative variables. For comparisons, the Kruskal-Wallis test will be used for non-parametric data. Correlations will be sought using the Pearson test. The statistical package SPSS Statistics 25 (IBM, New York, USA) will be used.

The evaluation of cataract surgery in patients with these characteristics is of utmost importance, although an increase in the risk of complications during the procedure has been observed, some authors document that there is no statistically significant difference. Good pharmacological dilation can reduce stress on the capsule as it will allow the creation of an appropriately sized capsulorhexis, which can be useful for the subsequent steps during surgery.