Visual Outcome of Cataract Surgery in Patients with Pseudoexfoliative Syndrome in Kelantan - A 10 Year Review.

Abstract

Purpose: To investigate the visual outcome and the contributing factors post cataract surgery in patients with pseudoexfoliative syndrome (PXS).
Method: This is a retrospective study among PXS patients who underwent cataract surgery with IOL implantation in a tertiary center, Kelantan, Malaysia from 2015 to 2024. Data was retrieved from the web-based Malaysian Cataract Surgery Registry (CSR). Visual outcomes w ere classified as good if visual acuity was 6/12 or better, and poor if 6/18 or worse, taken from 6 weeks postoperatively onwards. Factors affecting poor visual outcomes (age group, gender, systemic comorbidity, and presence of other complications intraoperatively) were analysed using logistic regression to produce adjusted odds ratio (OR) for variables of interest.
Results: Out of 74 patients with PXS who underwent cataract surgery, 61 (83.7%) cases were qualified. Most patients 38(62.3%) achieved a good visual outcome. In the simple logistic regression, vitreous loss (OR = 4.243, P = 0.024) and type of surgery in which Extracapsular cataract extraction (ECCE) (OR = 0.215, P = 0.017) were significantly associated with visual outcomes postoperatively.
Conclusion: Cataract surgeries in patients with PXS achieved good visual outcomes. Vitreous loss and the choice of operative technique, specifically ECCE, were the significant factors influencing postoperative visual outcomes in cataract surgery with PXS. Despite the higher complication rates associated with PXS, timely identification, careful selection of surgical approach, and adoption of appropriate precautions can reduce these risks and achieve a good visual outcome.