"Phacoemulsification In Patients With Capsular Pseudoexfoliation – Challenges For Young Residents"

The purpose of this study is to evaluate the technical challenges and outcomes of cataract surgery through phacoemulsification (PKE) in patients with capsular pseudoexfoliation syndrome (PEX), particularly focusing on the difficulties faced by young residents during the procedure.

This study was conducted at a university-affiliated hospital with a teaching program, where surgeries were performed by young ophthalmology residents under supervision. All surgeries were performed using the same equipment and standardized protocols.

We conducted a prospective study over 1 year, including 60 patients: 30 with PEX and 30 without. All surgeries were performed by residents using the same machine, with no other conditions predisposing to surgical complications. Postoperative complications and visual acuity were monitored.

Young residents faced more technical difficulties in the PEX group, with poorer pupillary dilation (21% vs. 6% in the control group) and more frequent zonular ruptures (11.4% vs. 2.9%). In 23% of cases, residents handed over the procedure to a senior surgeon. Despite these challenges, serious complications were low in both groups. At one month, visual acuity recovery was similar in both groups. To sum up, these complications did not negatively impact short-term visual outcomes. Mastery of surgical techniques (iris hooks, capsular tension rings) seemed to mitigate the residents' limited experience. Senior surgeons played a crucial role in ensuring favorable outcomes

A young resident's experience can influence the management of cataract surgery in PEX patients, but visual prognosis remains similar to that of patients without PEX.