Quantitative assessment of aqueous flare and aqueous 'cells' in pseudoexfoliation syndrome

We used the laser flare-cell meter to measure aqueous flare and aqueous 'cells' in 38 eyes of 38 patients with pseudoexfoliation, in 36 normal control eyes of 36 subjects, and in 19 eyes of 19 patients with chronic open-angle glaucoma unrelated to pseudoexfoliation. In pseudoexfoliation eyes, both aqueous flare (0.61 +/- 0.55 mg/ml human albumin equivalent) and aqueous 'cells' (mean 10.70, range 0-50.6 cells/0.075 mm3) were significantly higher than in the normal control group (flare 0.15 +/- 0.06 mg/ml, 'cells' 0.43, range 0-2, P less than 0.0001) and in the glaucoma group without pseudoexfoliation (flare 0.19 +/- 0.08 mg/ml, 'cells' 0.80, range 0-2.4, P less than 0.0001 and P less than 0.005). No significant difference could be found between the flare and cell counts of normal eyes and glaucoma eyes without pseudoexfoliation (P greater than 0.09, P greater than 0.05) and between PSX eyes with (18 eyes) and without (20 eyes) open-angle glaucoma (P greater than 0.99, P greater than 0.4). Our findings indicate that the blood-aqueous barrier is impaired in eyes with pseudoexfoliation, and that the laser flare-cell meter may be a useful tool to quantify these changes. These alterations of the blood-aqueous barrier need to be considered in medical therapy and intraocular surgery.