Aravind Pseudoexfoliation Study: 1-Year Postoperative Results
Narrative Responses:
Purpose
There is a controversy over both the intraoperative and late postoperative complications of cataract surgery in pseudoexfoliationeyes. We performeda prospective controlled randomized 6-armed studyto evaluate the effects of different IOL styles and CTRs on complications in XFS eyes undergoing phacoemulsification without prior clinical lens subluxation.
Methods
We enrolled subjects with graded clinical XFS with or without glaucoma without preexisting phacodonesis, requiring phaco between December 2010 and October 2011. The control group had no XFS but underwent phaco. The eyes with XFS were randomized into four groups at the time of IOL implantation: Single piece Acrysof IOL with and without CTR and 3-piece Acrysof IOL with and without CTR. All surgical and late postoperative complicationswerenoted and analysed for each of 2 groups. Eyes were followed intraoperatively, at 1 day, 1, 3 and 6 months, 1 year, and will be followed up yearly for 10 years.
Results
We report the one year postoperative results of 846 XFS eyes and 450 controls.Mean IOP was 12.9(2.7) XFS & 12.8(3.3) Control, (p=0.884).The mean endothelial cell densities were 1833.5(404.3) XFS & 1964.8(406.5) Control, (p<0.001).There were no significant differences in IOL subluxation (0.4 % vs. 0.2%, p=1.0), posterior capsular opacification (8.9% vs. 8.7%, p=0.909),or new onset of glaucoma (1.2 % vs0.7 %, p=0.560) between the two groups.There was no significant intergroup difference as well in the above variables. The one year, corrected distance VA>6/9 was 98.5 % XFS compared to 98.7 % controls (p=1.000).
Conclusion
Along with a low intraoperative complication rate, no significant differencein complications was detected at 1 year postoperative irrespective of IOL type or use of a CTR.However longer follow-up will reveal if lens choice or the use of a CTR is related to clinically significant late post op complications.