A Study on Comparison of phaco-nucleotomy techniques in management of pseudoexfoliation syndrome

Pseudoexfoliation syndrome is a common clinically important systemic condition characterized by the pathological production and accumulation of an abnormal fibrillar extracellular material in many intraocular and extraocular tissues. Many studies have shown that pseudoexfoliation syndrome patients with higher rates of intraoperative complications during cataract surgery compared to the patients without it. The present study is undertaken to compare phaco chop and divide and conquer techniques of phacoemulsification, in the management of pseudoexfoliation syndrome in terms of intraoperative complications. It is a hospital based prospective study of 90 patients with cataract and pseudoexfoliation syndrome attending GEMS Hospital, Srikakulam. The average age of patients in the study was 61.7 years with a male preponderance with equal incidence of unilateral and bilateral involvement. 97.8% of the patients were implanted with intraocular lens after the employment of various surgical modifications. Intraoperative complications noted in vertical chopping technique was only pupil constriction in 6.7%, whereas in horizontal chopping 13.3% had pupil constriction, 6.7% had difficulty in chopping, 3.3% had zonular dehiscence and 3.3% had PC Rent. In divide and conquer technique 16.7% had pupil constriction, 10% had difficulty in trenching, 3.3% had PC Rent. Though phacoemulsification surgery in eyes with pseudoexfoliation syndrome is associated with intraoperative complications, vertical chopping technique scores over horizontal chopping and divide and conquer technique of phacoemulsification with good surgical outcome because of less complications.