title: Mature cataracts increase risk of capsular complications in manual small-incision cataract surgery of pseudoexfoliative eyes.
abstract: BACKGROUND
  To evaluate rates of intraoperative posterior capsule complications in manual small-incision cataract surgery of eyes with and without pseudoexfoliation syndrome in terms of cataract maturity level.
  
  
  METHODS
  We identified patients who had undergone manual small-incision cataract surgery between January 1997 and October 2003 from a review of patient charts. Preoperative data collected were cataract maturity level, best corrected visual acuity, and intraoperative posterior capsule complications as documented in the surgical report, namely (1) posterior capsule rupture or zonulolysis, or both, and (2) vitreous loss.
  
  
  RESULTS
  Two hundred and twenty-five eyes of 187 patients met the study criteria, of which 99 eyes had pseudoexfoliation syndrome (group 1) and 126 did not (group 2). Intraoperative posterior capsule complications occurred in 18 eyes (18%) in group 1 and 7 eyes (5.5%) in group 2 (difference was significant at p=0.003). The rate of capsular complications was significantly higher in both groups for eyes with preoperative visual acuity worse than 20/200 than for eyes with 20/200 or better. The number of eyes with visual acuity worse than 20/200 (counting fingers, hand motion, or light perception) was 70 (70%) in group 1 and 63 (50%) in group 2. Mature or brunescent cataract occurred in 49.5% of group 1 eyes and 26% of group 2 eyes.
  
  
  CONCLUSIONS
  In manual small-incision cataract surgery, pseudoexfoliation syndrome has an increased intraoperative posterior capsule complication rate that increases as the level of cataract maturity increases and the preoperative visual acuity decreases.
authors.affiliation: Department of Ophthalmology, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. hbayramlar@yahoo.com
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bayramlar
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Hepsen
authors.forename: Harun
authors.initials: H
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000145:classification / Q000150:complications*; D002387:Cataract Extraction / Q000009:adverse effects*; D017889:Exfoliation Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D007905:Lens Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014792:Visual Acuity