Frequency, clinical characteristics and cataract surgery outcomes of pseudoexfoliation syndrome in patients with senile cataracts: a review of hospital-based data

To investigate the frequency of pseudoexfoliation syndrome (PEXS), its ocular and systemic clinical features in patients scheduled for cataract surgery, and to evaluate surgical complications and outcomes. Data from 585 eyes that underwent cataract surgery were included in this retrospective study. Data retrieved from patient files and our hospital's electronic medical records were reviewed, including the presence of PEXS, pupil dilation, cataract type, nuclear hardness according to Lens Opacities Classification System III, and glaucoma. Additionally, data on clinical characteristics of pre-existing systemic diseases, surgical outcomes, and intraoperative and postoperative complications were also noted. The data were analyzed between two groups: eyes with PEXS and eyes without PEXS. The frequency of PEXS was 10.7%. The most common type of cataracts in the PEXS group was nuclear cataracts. Nuclear cataracts were harder in eyes with PEXS than in eyes without PEXS. Mean intraocular pressure was significantly higher in eyes with PEXS than in eyes without PEXS (p = 0.001). The prevalence of glaucoma was significantly higher in the PEXS group (p = 0.001). There was no statistically significant difference between the two groups in terms of the frequency of intraoperative and postoperative complications. The non-PEXS group showed significantly better best-corrected visual acuity (BCVA) compared to the PEXS group at the first week postoperatively (p = 0.001). However, BCVA was comparable between groups at the one-month postoperative visit. The frequency of PEXS was relatively high in our study. Awareness of the potential risks associated with PEXS in cataract surgery is essential, and appropriate preparations, including necessary surgical tools and techniques, should be made to ensure optimal outcomes. Although no differences were observed in the rates of intraoperative complications between the groups, this finding should be interpreted cautiously and should not be considered as evidence of equivalent surgical risk.