AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome(PEX)and the usage of proper surgical techniques and appropriate devices intraoperatively.

METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens(IOL)implantation surgery were evaluated retrospectively. The mean age was 71.68±9.96(53-89)y, and there were 24(45%)males and 29(55%)females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.

RESULTS: Nuclear cataract was significantly more common than other types(P=0.00). The mean preoperative best corrected visual acuity(BCVA)was 0.99±0.30(SD)(0.40-1.50)logMAR, and the mean postoperative BCVA was 0.32±0.31(SD)(0.00-1.00)logMAR(P=0.00). Iris retractors were used in 12(18%)eyes. Capsular tension ring(CTR)implantation was used in 15(22%)eyes, it was planned in 8(12%)and unplanned in 7(10%). Posterior capsule rupture occurred in 4(6%)eyes, and vitreous loss occurred in 2(3%)eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction(ECCE)was needed in these 2(3%)eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4(6%)eyes, and anterior chamber reaction in 5(7%)eyes. IOL dislocation occurred in 4(6%)eyes, but repositioning was only needed in 1(1.5%)eye. Posterior capsule opacification(PCO)requiring Nd:YAG laser capsulotomy developed in 13(20%)eyes.

CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.