Prevalence of cataract complications in patients with pseudoexfoliation syndrome in Northwestern Spain

ABSTRACT Purpose: To assess the relationship between pseudoexfoliation syndrome and incidence of complications and related clinical factors in patients undergoing cataract surgery. Methods: We conducted a retrospective cohort study of 503 of 551 patients who underwent phacoemulsification surgery over 2 years in a health care district in Northwest Spain. In total, 120 of 681 eyes undergoing the procedure had pseudoexfoliation syndrome. Data on the surgical procedure and associated complications were extracted from the medical record. Complications included any combination of posterior capsular rupture, vitreous loss, zonular dialysis, and nuclear or lens luxation. Results: We found a significant association between pseudoexfoliation syndrome and zonular dialysis (odds ratio [OR], 6.89; 95% CI, 2.27-20.93), intraoperative miosis (OR, 2.15; 95% CI, 1.10-4.22), and lens luxation >1.5 mm (OR, 9.49; 95% CI, 0.85-105.54). However, when adjusting for the overall risk of complications in pseudoexfoliation syndrome patients in consideration of myopia, use of anticoagulants or α-agonists, previous mydriasis, and anterior chamber length, the OR decreased to 1.02 (95% CI, 0.47-2.21) and was therefore not significant. Conclusion: Zonular dialysis and intraoperative miosis were intraoperative complications in cataract surgery patients with pseudoexfoliation syndrome when compared to controls.

摘要
目的：评估假性剥脱综合征（pseudoexfoliation syndrome）与接受白内障手术患者的并发症发生率及相关临床因素之间的关联。
方法：本研究为回顾性队列研究，纳入西班牙西北部某医疗区域2年间收治的551例行超声乳化白内障吸除术（phacoemulsification surgery）患者中的503例。其中共计681只术眼接受手术，120只眼合并假性剥脱综合征。研究人员从患者病历中提取手术操作及相关并发症的详细数据，并发症包括后囊膜破裂、玻璃体脱出、晶状体悬韧带离断（zonular dialysis）及核性或晶状体脱位等任意组合。
结果：本研究发现，假性剥脱综合征与晶状体悬韧带离断（比值比OR=6.89；95%置信区间CI=2.27~20.93）、术中缩瞳（OR=2.15；95%CI=1.10~4.22）以及晶状体脱位＞1.5mm（OR=9.49；95%CI=0.85~105.54）存在显著统计学关联。但在校正近视、抗凝药物或α肾上腺素能激动剂使用史、既往散瞳史及前房长度等混杂因素后，假性剥脱综合征患者的总体并发症风险比值比降至1.02（95%CI=0.47~2.21），该关联不再具有统计学显著性。
结论：与对照组相比，合并假性剥脱综合征的白内障手术患者术中并发症以晶状体悬韧带离断及术中缩瞳为主。