Pseudoexfoliation syndrome in patients scheduled for cataract surgery

Purpose
We present the results of a prospective investigation into the frequency of pseudoexfoliation syndrome (XFS), age, sex, intraocular pressure (IOP) and the type of lens opacity in patients scheduled for cataract surgery.

Material and methods
A series of 1000 consecutive patients (604 females and 396 males in the age from 26 to 97 years), who were admitted for cataract surgery to the Department of Ophthalmology of Medical University in Bialystok, were studied. All eyes were examined with a slit-lamp biomicroscope before and after mydriasis with 1% tropicamide and 10% phenylephrine to find out the exfoliation. The type of cataract was classified as mainly nuclear, cortical, posterior subcapsular, mixed, mature or hypermature. Glaucoma was defined as IOP ≥ 21 mmHg with optic disc and/or visual field changes indicative of glaucoma.

Results
Exfoliation material was detected in 82 patients (8.2%). The mean age of patients with XFS (77.1 ± 9.3 years) was significantly more than that of those without XFS (65.6 ± 11.2 years), p < 0.01. The prevalence of XFS significantly increased with advancing age. Mature cataract and nuclear sclerosis predominated in eyes with XFS (32.9% and 24.4%, respectively) compared to those without XFS (24.6% and 14.2%), p < 0.05. Posterior subcapsular cataract was less common in eyes with exfoliation (9.7%) than in eyes without it (39.1%), p < 0.001. The mean preoperative intraocular pressure was higher in eyes with XFS (17.8 ± 3.2 mmHg), than in those without XFS (15.2 ± 3.8 mmHg), p < 0.01. Glaucoma was found in 28 of 82 eyes with pseudoexfoliation syndrome (34.1%).

Conclusions
The pseudoexfoliation syndrome occurred much more frequently in elderly persons. PEX has been found to be associated with higher mean intraocular pressure, glaucoma, mature and nuclear cataract. Posterior subcapsular cataract was less common in patients with PEX.