Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 12;13(5):818.
doi: 10.3390/jpm13050818.

Long-Term Evaluation of Pseudoexfoliation Syndrome Post-Cataract Extraction

Karny Shouchane-Blum  1   2 , Alon Zahavi  1   2 , Noa Geffen  1   2 , Yoav Nahum  1   2 , Eitan Livny  1   2 , Irit Rosenblatt  1   2 , Ruti Sella  1   2 , Irit Bahar  1   2 , Amir Sternfeld  1   2 , Dan Gaton  1   2
Affiliations

Long-Term Evaluation of Pseudoexfoliation Syndrome Post-Cataract Extraction

Karny Shouchane-Blum et al. J Pers Med. .

Abstract

The study aimed to examine the effect of cataract extraction on ophthalmologists' ability to detect pseudoexfoliation (PXF) syndrome. A total of 31 patients admitted for elective cataract surgery were enrolled in this prospective comparative study. Prior to surgery, patients underwent slit-lamp examination and gonioscopy conducted by experienced glaucoma specialists. Subsequently, patients were re-examined by a different glaucoma specialist and comprehensive ophthalmologists. Pre-operatively, 12 patients were diagnosed with PXF on the basis of a Sampaolesi line (100%), anterior capsular deposits (83%), and pupillary ruff deposits (50%). The remaining 19 patients acted as controls. All patients were re-examined 10-46 months post-operatively. Of the 12 patients with PXF, 10 (83%) were correctly diagnosed post-operatively by glaucoma specialists and 8 (66%) by comprehensive ophthalmologists. There was no statistically significant difference in PXF diagnosis. However, detection of anterior capsular deposits (p = 0.02), Sampaolesi lines (p = 0.04), and pupillary ruff deposits (p = 0.01) were significantly lower post-operatively. Diagnosis of PXF is challenging in pseudophakic patients as the anterior capsule is removed during cataract extraction. Therefore, PXF diagnosis in pseudophakic patients relies mainly on the presence of deposits at other anatomical sites, and careful attention to these signs is required. Glaucoma specialists may be more likely than comprehensive ophthalmologists to detect PXF in pseudophakic patients.

Keywords: cataract; glaucoma; pseudoexfoliation syndrome; pseudophakia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Difference in detecting various PXF findings between non-glaucoma and glaucoma specialists. (a) Detection of deposits on anterior capsule; (b) detection of deposits on pupillary ruff; (c) detection of a Sampaolesi line. p < 0.05 is considered statistically significant.
Figure 2
Figure 2
Number of sites involved (anterior capsule, pupillary ruff, iridocorneal angle, corneal endothelium, or presence or absence of a Sampaolesi line) in diagnosis of pseudoexfoliation (a) before and (b) after surgery, as was documented by a glaucoma specialist.
See this image and copyright information in PMC

References

    1. Belovay G.W., Varma D.K., Ahmed I.I.K. Cataract surgery in pseudoexfoliation syndrome. Curr. Opin. Ophthalmol. 2010;21:25–34. doi: 10.1097/ICU.0b013e328332f814. - DOI - PubMed
    1. Elhawy E., Kamthan G., Dong C.Q., Danias J. Pseudoexfoliation syndrome, a systemic disorder with ocular manifestations. Hum. Genom. 2012;6:22. doi: 10.1186/1479-7364-6-22. - DOI - PMC - PubMed
    1. Nazarali S., Damji F., Damji K.F. What have we learned about exfoliation syndrome since its discovery by John Lindberg 100 years ago? Br. J. Ophthalmol. 2018;102:1342–1350. doi: 10.1136/bjophthalmol-2017-311321. - DOI - PubMed
    1. Ritch R., Schlötzer-Schrehardt U. Exfoliation syndrome. Surv. Ophthalmol. 2001;45:265–315. doi: 10.1016/S0039-6257(00)00196-X. - DOI - PubMed
    1. Mitchell P., Wang J.J., Hourihan F. The relationship between glaucoma and pseudoexfoliation: The Blue Mountains Eye Study. Arch. Ophthalmol. 1999;117:1319–1324. doi: 10.1001/archopht.117.10.1319. - DOI - PubMed