Aims To predict high-risk factors for zonular complications during cataract surgery due to pre-existing severe zonular dehiscence in eyes with pseudoexfoliation (PXF) syndrome. Methods 315 eyes of 315 consecutive patients with PXF scheduled for phacoemulsification surgery underwent preoperative examination of various ocular parameters using an anterior segment-optical coherence tomography and other devices. When zonular complications occurred during surgery due to zonular dehiscence, scleral fixation of the intraocular lens (IOL) or implantation of a capsular tension ring (CTR) was performed. High-risk factors for these intraoperative zonular complications were examined using classification-tree and logistic regression analyses. Results Of the 315 eyes, 31 (9.84%) underwent scleral IOL fixation or CTR implantation. High-risk factors identified by classification-tree analysis were a small pupillary diameter after mydriasis <6.30 mm, a shallow anterior chamber depth <2.074 mm and lens decentration >0.260 mm. Based on exact logistic regression analysis, the OR was 4.81-fold higher for eyes with poor mydriasis than for eyes without poor mydriasis (p=0.006, 95% CI 1.49 to 18.23), 23.99-fold higher for eyes with poor mydriasis and a shallow anterior chamber (p<0.001, 5.92 to 109.02) and 287.39-fold higher for eyes with poor mydriasis, a shallow chamber and great lens decentration (p<0.001, 50.46 to infinity). Conclusion In eyes with PXF, high-risk factors for zonular complications during cataract surgery due to pre-existing severe zonular dehiscence were poor mydriasis, shallow anterior chamber and large lens decentration, suggesting the importance of evaluating these conditions preoperatively. Data are available upon reasonable request.

中文翻译：

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假性剥脱综合征眼白内障手术中小带并发症的高危因素


目的 预测白内障手术期间因患有假性剥脱 (PXF) 综合征的眼睛预先存在的严重小带裂开而导致小带并发症的高危因素。方法 连续 315 例 PXF 患者的 315 只眼睛计划进行超声乳化手术，使用眼前节光学相干断层扫描和其他设备对各种眼部参数进行术前检查。当手术中因小带裂开而出现小带并发症时，需进行人工晶状体巩膜固定（IOL）或植入囊膜张力环（CTR）。使用分类树和逻辑回归分析检查这些术中小带并发症的高风险因素。结果 315眼中，31眼（9.84%）接受巩膜IOL固定或CTR植入术。通过分类树分析确定的高危因素是散瞳后瞳孔直径<6 id=34>0.260 mm。根据精确逻辑回归分析，散瞳不良眼的 OR 比散瞳不差眼高 4.81 倍（p=0.006，95% CI 1.49 至 18.23），散瞳差且浅瞳孔的 OR 高 23.99 倍。前房（p<0.001，5.92 至 109.02）对于散瞳不良、浅房和较大晶状体偏心的眼睛（p<0.001，50.46 至无穷大）高出 287.39 倍。结论 对于 PXF 眼，由于先前存在的严重小带裂开而导致白内障手术中小带并发症的高危因素是散瞳不良、浅前房和大晶状体偏心，提示术前评估这些情况的重要性。数据可根据合理要求提供。