The Aravind Pseudoexfoliation Study

Haripriya, Aravind; Ramulu, Pradeep Y.; Chandrashekharan, Shivkumar; Venkatesh, Rengaraj; Narendran, Kalpana; Shekhar, Madhu; Ramakrishnan, Rengappa; Ravindran, Ravilla D.; Robin, Alan L.

doi:10.1016/j.ophtha.2018.10.027

Cited by 16 publications

(9 citation statements)

References 32 publications

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“…This is comparable to other studies that also found good VA outcomes after cataract surgery in PXF. 2,8,19 Predictability was excellent, in contrast to other publications reporting a high risk of refractive surprise in patients with PXFG. 20 It is difficult to assess the actual effect of some surgical factors, such as the use of CTR or FLACS, in the final outcomes among groups.…”

Section: Discussioncontrasting

confidence: 74%

“…Sometimes, this may result in surgeons facing possible associated challenging pathologic features, such as denser cataracts, shallow anterior chamber depth, small pupils, or phacodonesis, which can eventually increase the risk of complications. 1,2,8,17 Although a systematic classification to assess cataract opacity was not used in the present study, the preoperative CDVA may be used as an indirect indicator: 0.3 logMAR in the symmetric group and 0.2 logMAR in the asymmetric group, which were better than those reported by Shingleton et al 18 (0.5 log-MAR), Burgmüller et al 4 (0.8 logMAR), or Haripriya et al 8 (0.7 logMAR). This is consistent with a "quick" approach to phacoemulsification, close to the identification of the disease, and when cataracts tend to be less dense and CDVA is more preserved.…”

Section: Discussioncontrasting

confidence: 48%

“…7,17,21 Our rates of intraoperative complications were similar to those already published for PXF cases. 8 Despite the low rate (3.4%), it should be noted that all complications were found in symmetric PXF patients. Only 10 cases of IOL dislocation were detected, none of them belonging to the asymmetric PXF group, which is similar to the published rates.…”

Section: Discussionmentioning

confidence: 83%

“…28 Despite the lack of evidence to determine which is the best surgical technique in PXF cases, 1 current phacoemulsification technology has shown that it allows safe, effective, and predictable surgery to be carried out, with a very low rate of intraoperative complications. 8 Consequently, the removal of the crystalline lens as soon as possible could theoretically reduce part of the pathophysiological mechanisms associated with PXF, especially those related to the friction of the cells of the anterior capsule on the lens, certain mechanical stress factors on the zonule, etc. 29 The main limitations of this study are related to its retrospective design.…”

Section: Discussionmentioning

confidence: 99%

“…However, PXF is a heterogeneous syndrome and can present as a wide variety of clinical scenarios. 8 Indeed, it is currently accepted that PXF is actually a bilateral syndrome 9,10 and can be described as clinically asymmetric in 48%-76% of cases. 11,12 In those apparently monocular cases, the intraocular pressure (IOP) is on average 2 mm Hg higher in the affected eye compared with the nonaltered eye.…”

mentioning

confidence: 99%

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Early Lensectomy in Patients With Pseudoexfoliation: Long-Term Effectiveness and Safety Outcomes

Rodríguez-Uña

Cueto

Rodríguez-Calvo

et al. 2022

Journal of Glaucoma

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Précis: Early lensectomy in patients presenting pseudoexfoliation (PXF) in an asymmetric clinical stage resulted in effective, safe, and predictable long-term results. Good intraocular pressure (IOP) was found, thus it might be considered as a possible surgical approach in these patients. Purpose:The purpose of this study is to assess the long-term effectiveness, predictability, and safety of cataract surgery performed in patients with capsular PXF at an early stage of the disease. Materials and Methods:This retrospective, comparative study included PXF patients who underwent phacoemulsification with hydrophobic acrylic intraocular lens implantation in both eyes with a postoperative follow-up ≥ 5 years. Patients were classified in 2 groups: symmetric PXF (n = 102) and asymmetric PXF (n = 59). Preoperative and postoperative uncorrected and corrected distance visual acuity, manifest refraction, IOP, number of hypotensive drugs, visual field mean deviation, and the incidence of complications were registered.Results: The mean follow-up time was 8.5 ± 2.8 years. Six months after cataract surgery, monocular uncorrected and corrected distance visual acuity were 0.3 ± 0.4 and 0.1 ± 0.3 logMAR, respectively, for the symmetric PXF, and 0.2 ± 0.2 and 0.1 ± 0.2 logMAR, respectively, for the asymmetric group. Total 95% and 96% of eyes were within ± 1.00D in symmetric and asymmetric groups, respectively. At the final follow-up, IOP decreased only in the asymmetric group (P = 0.004), with a reduction in the number of medications in both eyes (P < 0.001). Mean deviation changed from −8.8 to −11.6 dB in the symmetric group (P < 0.001), and from −5.0 ± 6.2 to −7.9 ± 10.6 dB (P = 0.42) in the asymmetric group. Intraoperative complications were only registered in the symmetric group: 7 (3.4%; P = 0.04). Ten cases (4.9%) of late intraocular lens dislocation were found, all from the symmetric group (P = 0.03).Conclusions: Early lensectomy in patients with PXF before its symmetric presentation resulted in effective, safe, and predictable long-term results.

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