Cataract Surgery in Pseudoexfoliation Syndrome Using the Eight-Chop Technique

Objectives: To evaluate the safety and efficacy of the eight-chop technique in cataract surgery in patients with pseudoexfoliation (PEX) syndrome and assess the intraoperative parameters, changes in corneal endothelial cells, intraocular pressure (IOP), and intraoperative complications. Methods: This technique was applied in patients with and without PEX syndrome. Best-corrected visual acuity, IOP, corneal endothelial cell density (CECD), coefficient of variation, percentage of hexagonal cells, and central corneal thickness were assessed pre- and postoperatively. Operative time, phaco time, aspiration time, cumulative dissipated energy (CDE), and volume of fluid used were recorded intraoperatively. Results: We analyzed 219 eyes from 150 patients (mean age, 75.5 ± 5.7 years; 58 men, 92 women). In the PEX group, the mean operative time, phaco time, aspiration time, CDE, and volume of fluid used were 6.5 min, 16.8 s, 83.8 s, 6.67, and 32.9 mL, respectively, demonstrating favorable surgical metrics. In addition, CECD loss was 1.1% and 0.5% at 7 and 19 weeks, respectively, with no significant decrease observed post-surgery in the PEX group. No eye in the PEX group required a capsular tension ring due to zonular dialysis. Conclusion: The eight-chop technique in cataract surgery demonstrates excellent intraoperative parameters in patients with PEX, is effective against zonular weakness, and does not require the use of a capsular tension ring. This technique will aid in establishing personalized treatment strategies and improve cataract management and treatment.