Cataract surgery in the setting of pseudo-exfolation is particularly challenging due to the structural weakness that occurs with this disease process. The pupil dilation becomes poor and the zonular support becomes weak as the pseudo-exfoliative process continues over the years. The incidence of pseudo-exfoliation varies depending on patient population, geography, and age. It tends to be more common in older patients as well as those with Scandinavian ancestry, but it has certainly been found to varying degrees in just about all populations across the globe. These four videos highlight the range of challenges that are to be expected when performing cataract surgery on patients with pseudo-exfoliation. I am sure that you will learn a lot from this playlist.
Let’s start with a review video which will go over many of the foundations of the surgical principles that we will need to successfully perform cataract surgery for our pseudo-exfoliation patients.
Next up is a complete cataract case, shown from start to finish, of the typical degree of pseudo-exfoliation that we encounter in our private clinic and Beverly Hills surgery center.
This is another routine pseudo-exfoliation case, but done using a supra-capsular chop technique. This is helpful for our pseudo-exfoliation patients who have smaller pupils.
The final case is a very difficult one where the zonular laxity was severe due to extensive pseudo-exfoliation. In addition, the patient has a tiny eye with a shallow anterior chamber. We end up needing a capsular tension ring to help provide support as we insert the +34 D IOL.
Professor Uday Devgan MD is a Los Angeles Cataract Surgeon who authors CataractCoach.com to teach the best techniques of Cataract Surgery to Eye Surgeons from around the world.
View all posts by Uday Devgan MD
