Exfoliation syndrome (XFS), which is associated with increased surgical complications during phacoemulsification, has relatively high incidence in Greece. Multiannual surgical experience in XFS patients has led to the clinical observation that hydrodissection occurs more easily in XFS patients.
To compare the ease of hydrodissection in cataract patients with and without XFS.
One hundred and fifteen patients with senile cataract were included in the study. Forty-two out of them had XFS. All patients underwent uneventful phacoemulsification by the same surgeon. For hydrodissection, three 1 ml insulin syringes were filled with 0.5ml balanced salt solution (BSS). Sequentially, each one was quickly and continuously injected underneath 3rd, 6th and 9th hours of the anterior lens capsule. When lens mobilization was achieved with this procedure, hydrodissection was characterized as “easy”.
The two groups were matched for the age, the gender, the biomicroscopic type of cataract and the presence of diabetes mellitus. Glaucoma was more often in XFS patients (p=0.002). In 39 out of 42 exfoliation patients (92.8%) “easy” hydrodissection was recorded. In the control group, the corresponding numbers were 47 out of 73 (64.3%). The two groups differed significantly (p=0.001).
Hydrodissection was more easily performed in XFS patients compared to control group. This finding could be related to the extensive ultrustructural subepithelial alterations of the anterior lens capsule in exfoliation syndrome, recently described in own electron microscopy studies. We suggest that less BSS can be used for hydrodissection in XFS patient during phacoemulsification.

© 2020 S. Karger AG, Basel.