Pseudoexfoliation of lens capsule
Pseudoexfoliation cataract
Pseudoexfoliation and cataract surgery
Pseudoexfoliation after cataract surgery
Pseudoexfoliation and pigment dispersion
Pseudoexfoliation and glaucoma
Pseudoexfoliation
Pseudoexfoliation syndrome is an age-related systemic eye problem that affect ocular tissues through the gradual deposition of fibrillary white flaky material from the crystelline lens, mainly on the lens capsule, ciliary body, zonules, corneal endothelium, iris and pupillary margin.
Pseudoexfoliation is also called as PXF and PEX.
It is very common eye problem seen in cataract diagnosed patient in preoperative examination.
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Causes of Pseudoexfoliation
The causes of Pseudoexfoliation is a well-recognized late-onset disease caused by a generalized fibrillopathy.
It is ocular complications including glaucoma and perioperative problems during cataract surgery.
Diagnosis of PXF
Diagnosis of Pseudoexfoliation is made using slit lamp biomicroscopy or under operative microscope and intraocular pressure measurement (IOP).
Deposition of white fluffy material on the anterior lens capsule and pupillary margin and iris transillumination defects can be visualized in many cases.
Gonioscopy may show increased pigment deposit on the trabecular meshwork of ciliary body.
Physical examination
Examination for Pseudoexfoliation with following point should be remembered...
• Increased intraocular pressure more than 21 mmhg
• Possible glaucomatous damage to optic nerve
• Poor dilation with peripupillary transillumination defect
• Fibrillar white flaky deposits on the anterior lens capsule
• Fibrillar white flaky deposits on at pupillary border
• Hyperpigmentation of the trabecular meshwork with an open angle on gonioscopy
Management of PXF syndrome
1. Routine regular eye exam
2. Glaucoma monitoring and treatment if diagnosed
3. Special surgical considerations for cataract surgery pre-operatively, intra-operatively and post-operatively
Best medical tretment for PXF
1. Installed eye drops if the patient has glaucoma or glaucomatous symptoms.
2. Possible use of antioxidants
3. Lower Homocysteine if the level is high in plasma or tear film
Complications due to PXF
1. Glaucoma or optic nerve cupping
2. Cataract surgery complications:
- Drop nucleus or lens fragment
- Zonular dialysis
- Zonular weakness with or without phacodonesis
- Lens subluxation
3. Other systemic problems