Purpose: We investigated the clinical staging and management of cataracts to decrease the incidence of complications of phacoemulsification and improve the postoperative visual function of patients with exfoliation syndrome (XFS) with cataract.
Methods: Cataracts with XFS were divided into early, middle, and late stages using the Emery-Little lens opacities classification system. Phacoemulsification and intraocular lens (IOL) implantation were performed in all eyes. The incidences of intraoperative and early postoperative complications of phacoemulsification were compared, and differences in the outcomes of phacoemulsification were evaluated.
Results: There were 23, 31, and 34 eyes with early-, middle- and late-stage XFS, respectively. The mean ultrasound time, cumulative dissipated energy, and incidence of moderate to severe corneal edema and wound burn in the late-stage group were significantly higher than in the early- and middle-stage groups (p<0.05). The incidence of zonular dehiscence, capsular rupture, vitreous loss, and iritis were not significant among the 3 groups (p>0.05). Intraocular pressure rise in the early postoperative period and the level of optic atrophy in the late-stage group were significantly higher than in the other 2 groups (p<0.05). The gain in visual acuity in the early- and middle-stage groups after surgery was better than in the late-stage group of XFS, and the difference was statistically significant (p<0.05).
Conclusions: The clinical staging of cataract with XFS contributed to the choice of operation time and its management. Phacoemulsification and IOL implantation in early- and middle-stage XFS induced fewer complications and led to better recovery of visual function after surgery.