Phacoemulsification in pseudoexfoliation (PEX) syndrome.

The aim is to present the phacoemulsification phaco-chop technique in a patient with pseudoexfoliation (PEX) syndrome without the use of additional pupil dilatation methods. Phacoemulsification surgery and posterior chamber intraocular lens implantation in patients with PEX syndrome is associated with a higher rate of intraoperative complications such as zonular dehiscence, capsular rupture, vitreous loss and dropped nucleus. Many options are available for pupils that cannot be dilated sufficiently with pharmacologic agents, such as viscodilatation (Healon 5), bimanual stretching, iris retractor-hooks, and many others. We present cataract surgery in a patient with sufficient mydriasis despite PEX syndrome. The operation was done successfully without intraoperative and postoperative complications. It is concluded that cataract surgery in patients with PEX syndrome is more complicated because of zonular weakness and poor pupillary dilatation. Therefore, these patients should be managed with utmost care and operated on in time by an experienced surgeon.