Korean J Ophthalmol > Epub ahead of print
DOI: https://doi.org/10.3341/kjo.2021.0183    [Epub ahead of print]
Published online January 24, 2022.
Refractive Outcomes of Uneventful Cataract Surgery in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma
Hatice Tekcan, Mehmet S. Mangan, Serhat İmamoğlu, Oksan Alpogan
Health Sciences University Turkey, Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey
Correspondence:  Hatice Tekcan, Tel: +90 505 765 01 42, Fax: +90 216 2782617, 
Email: drhatice.doner@gmail.com
Received: 2 December 2021   • Revised: 27 December 2021   • Accepted: 22 January 2022
Abstract
Purpose
To compare the refractive outcomes after cataract surgery between patients with and without pseudoexfoliation, and to evaluate the risk factors of refractive error.
Methods
Retrospective review of 210 eyes with pseudoexfoliation (study group) and 510 normal eyes (control) that underwent uneventful phacoemulsification with intraocular lens implantation. The study group included pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) subgroups. The main outcome measure was refractive error, defined as the difference between the target refraction and postoperative refraction in diopter (D). A refractive error >± 1.0 D was identified as a large-magnitude refractive error. The frequency of the large-magnitude refractive error was compared between study and control groups, and also between each subgroups and normal eyes. The factors influencing refractive error were analyzed by logistic regression.
Result
s: There was a significantly higher frequency of a refractive error >± 1.0D and hyperopic error >1.0 D in the study group than in the control group (p=0.001, p=0.003; respectively). In the multivariate logistic regression analysis, PXG and poor preoperative visual acuity were related with a large-magnitude refractive error (p=0.001 and p=0.02, respectively) Refractive error >± 1.0 D and hyperopic error >1.0 D were noted more often in PXG eyes that had an intraocular pressure (IOP) spike >25 mmHg at postoperative first 24 hours (p=0.01, p=0.03; respectively).
Conclusions
The eyes with pseudoexfoliation were at high risk for refractive error, especially in the presence of glaucoma. In PXG, the only significant risk factor for refractive error was observed to be the presence of an IOP spike.
Key Words: Intraocular Pressure Spike, Pseudoexfoliation Glaucoma, Pseudoexfoliation Syndrome, Refractive Error, Uneventful Cataract Surgery
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