Prevention of pseudoexfoliation glaucoma in patients with age-related cataract in the background of pseudoexfoliation syndrome

Aim: To evaluate the possibility of using cataract phacoemulsification with simultaneous intraocular lens (IOL) implantation in patients with age-related cataract (ARC) combined with pseudoexfoliation syndrome (PES) as an algorithm for the pseudoexfoliation glaucoma (PEG) prevention.. Materials and Methods: A retrospective case-control study was conducted using data from medical records of 610 outpatients (813 eyes) with ARC aged from 49 to 79 years (average age 69 ± 3 years). Group 1 included 488 patients (625 eyes) with ARC and PES, and Group 2 (control) included 122 patients (188 eyes) without signs of PES. Patients in both groups underwent ultrasonic phacoemulsification and IOL implantation. Results: Patients from Group 1 presented with less anterior chamber depth, a thicker lens, and higher intraocular pressure (IOP), as compared to Group 2. In patients with PES after cataract surgery, we observed a slight increase in IOP during the first week, followed by a significant decrease (by 3.1 mm Hg) during the next 3 months (vs. baseline; p<0,001). In patients without PES, a slow decrease in IOP (by 1,0 mm Hg) was observed during 3 months after surgery (vs. baseline; p<0,001). The cataract surgery favored an increase in anterior chamber depth by 45,2 % in patients with ARC and PES. Conclusions: Ultrasonic cataract phacoemulsification with IOL implantation in patients with PES leads to a significant decrease and stabilization of IOP in the long-term postoperative period (3-month follow-up), and may be an alternative method for the prevention of PEG development.