Cataract Surgery in Pseudoexfoliation Syndrome Using the Eight-Chop Technique

Abstract

Objectives: This study aimed 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. Preoperative and postoperative assessments were conducted on best-corrected visual acuity, IOP, corneal endothelial cell density (CECD), coefficient of variation, percentage of hexagonal cells, and central corneal thickness. Intraoperative recordings included operative time, phaco time, aspiration time, cumulative dissipated energy (CDE), and fluid of volume used. Results: We analyzed 150 eyes from 150 patients (mean age, 75.5 ± 5.7 years; 59 men, 91 women). In the PEX group, operative time, phaco time, aspiration time, CDE, and volume of fluid used were 6.7 min, 17.4 s, 85.2 s, 6.91 µJ, and 33.4 mL, respectively, demonstrating favorable surgical metrics. On the other hand, in the control group, operative time, phaco time, aspiration time, CDE, and volume of fluid used were 4.5 min, 14.3 s, 64.0 s, 5.83 µJ, and 25.5 mL, respectively. In addition, CECD losses were 3.7% at week 7 and 2.7% at week 19 in the PEX group and 2.7% and 1.6%, respectively, in the control group. Significant decreases were observed at 7 and 19 weeks postoperatively in the PEX and control groups. No eye in the PEX group required a capsular tension ring due to zonular dialysis. Conclusions: 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.

This Zenodo record is a permanently preserved version of a Structured PREreview. You can view the complete PREreview at https://prereview.org/reviews/17275459.

Does the introduction explain the objective of the research presented in the preprint? Yes Authors mentioned: Therefore, we aimed to evaluate the efficacy of the eight-chop technique in patients with PEX syndrome who underwent cataract surgery. We examined intraoperative parameters, changes in corneal endothelial cells and IOP, as well as intraoperative complications Furthermore, we will verify the effectiveness of the eight-chop technique in patients with PEX syndrome, who are highly susceptible to corneal endothelial cell vulnerability and intraoperative complications. Additionally, we conducted an extensive literature search to examine the superiority of the eight-chop technique. We focused particularly on intraoperative parameters and postoperative corneal endothelial cell density loss. Our research on the eight-chop technique for patients with PEX syndrome aims to promote the development of personalized treatment strategies and ultimately contribute to cataract surgery.

Are the methods well-suited for this research? Somewhat appropriate In Section 2.7. Data Collection and Statistical Analysis Patients were closely monitored on postoperative days 1 and 2 and weeks 1, 3, 7, and 19. Postoperative outcome assessments including BCVA, IOP, CCT, CV, PHC, and CECD were conducted at 7 and 19 weeks postoperatively. Statistical analyses were performed using the Mann–Whitney U test to compare the results obtained from the two groups. The pre- and postoperative BCVA, IOP, CV, PHC, CCT, and CECD values were compared using a paired t-test. The chi-square test was used to determine whether sex-related differences were observed between the PEX and control groups. The sample size was determined using G-Power software (version 3.1.9.7) [26] to ensure that the study had sufficient statistical power to detect significant differences in the results. The parameters for the calculation were based on the data in our paper [18]. A p-value < 0.05 was considered statistically significant. However, the normality of data was not tested (at least not mentioned in the manuscript, and the normality test applied was also not provided) before the decision on the use of parametric or non-parametric tests.

Are the conclusions supported by the data? Highly supported

Are the data presentations, including visualizations, well-suited to represent the data? Somewhat appropriate and clear

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research? Very clearly

Is the preprint likely to advance academic knowledge? Somewhat likely Research on the eight-chop technique for cataracts with PEX will establish personalized treatment strategies and improve cataract management and treatment.

Would it benefit from language editing? No

Would you recommend this preprint to others? Yes, it's of high quality

Is it ready for attention from an editor, publisher or broader audience? Yes, as it is

Competing interests

The author declares that they have no competing interests.

Use of Artificial Intelligence (AI)

The author declares that they did not use generative AI to come up with new ideas for their review.

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Cataract Surgery in Pseudoexfoliation Syndrome Using the Eight-Chop Technique

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