Authors : Punit Singh, Deepak Patel
DOI : 10.18231/j.ijceo.2019.112
Volume : 5
Issue : 4
Year : 2019
Page No : 470-476
Pseudoexfoliation is a ubiquitous syndrome which is of multifactorial origin affecting elderly people
by increasing the risk of cataract and secondary glaucoma development. Despite modern techniques
and technologies for cataract surgery, pseudoexfoliation syndrome represents a challenge for surgeons
because of the increased weakness of the zonular apparatus and limited pupil dilation. Due to the
inherent difficulties during surgery, there is the risk of vitreous loss in these patients which is several
times higher than in cataract patients without pseudoexfoliation. Using currently available surgical devices
like ophthalmic viscosurgical device, iris retractors and ring dilators, capsular tension ring, etc., the risk
of intraoperative complications may be much reduced, allowing the surgeon to handle difficult cases
with greater confidence and safety. This review analyzes the methodologic approach to the patient with
zonular laxity with the aim of providing useful advices to limit the risks of intraoperative and postoperative
complications. From the preoperative planning, to the intraoperative management of the small pupil and
phacodonesis, and to the postoperative correction of capsule phimosis and intraocular lens dislocation, a
step approach to the surgical management of pseudoexfoliation patients is illustrated.
Keywords: Pseudoexfoliation,Cataract, Secondary glaucoma.