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Pseudoexfoliation syndrome: analysis of intraoperative complications during cataract surgery

Poster Details

First Author: M.Tijani MOROCCO

Co Author(s):    N. Albaroudi   N. Boutimzine   O. Cherkaoui              

Abstract Details


To compare intraoperative complications during phacoemulsification with and without pseudoexfoliation syndrome (PXF) and emphasize surgical pearls for better outcomes.


Ibn Sina university hospital (hôpital des spécialités), Department A of ophthalmology, Rabat, Morocco


In this retrospective study we reviewed the records of 208 patients admitted for cataract surgery between January 2016 and January 2017. All patients underwent a complete ophthalmic examination, which included visual acuity testing, Goldmann applanation tonometry, angle evaluation and slit lamp examination before and after dilation to look for PXE syndrome on the papillary margin and anterior capsule of the lens. All patients underwent phacoemulsification. Intra-operative complications in PXF and non-PXF groups were noted such as: use of pupillary expansion, posterior capsular rupture, zonular dehiscence, conversion to larger incision. The data results were analyzed using SPSS software.


The prevalence of PXF was 23.6%. The mean age (years) was 66.9 ± 10.1. PXF patients were older (p<0.05). Compared to the controls, PXF group had a history of glaucoma (23.9% vs 5.7%, p < 0.001). Intraoperative complications occurred in 51% of PXF cases vs 31.1% of non-PXF cases (p=0.016). The following complications occurred more frequently in cases with PXF compared to those without: zonular dialysis (14.3% vs 3.1%, p=0.003), small pupils (12.5% vs 1.3%, p=0.004), capsular tension ring usage (6.1% vs 0.6%, p= 0.04), posterior capsular rupture (28.6% vs 18.9%, p=0.14), conversion to larger incision (22.4% vs 15.7%, p=0.27).


Peroperative complications during phacoemulsification appear to be more frequent in exfoliation syndrome group. Therefore, vigilant slit lamp examination and careful planning of the procedure help anticipate potential intraoperative complications and achieve better visual outcomes.

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