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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Ocular parameter changes after phacoemulsification in pseudoexfoliative eyes: case-control study.

Ioannis Kassos1, Argyrios Tzamalis, Maria Dermenoudi

  • 1From the 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece (Kassos, Tzamalis, Koronis, Ziakas, Anastasopoulos); Health Center of Neapolis, Thessaloniki, Greece (Dermenoudi); Queen Victoria Hospital NHS Foundation Trust, London, United Kingdom (Matsou).

Journal of Cataract and Refractive Surgery
|January 24, 2022
PubMed
Summary

Phacoemulsification surgery in eyes with pseudoexfoliation syndrome (PEX) causes greater anterior chamber deepening and hyperopic shift compared to non-PEX eyes. This suggests PEX eyes may need adjusted target refraction for optimal outcomes.

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Area of Science:

  • Ophthalmology
  • Anterior Segment Surgery
  • Cataract Surgery

Background:

  • Pseudoexfoliation syndrome (PEX) is a common condition affecting the anterior segment of the eye.
  • Understanding the impact of cataract surgery on eyes with PEX is crucial for refractive outcomes.

Purpose of the Study:

  • To compare changes in angle morphometrics, anterior chamber depth (ACD), intraocular pressure (IOP), and endothelial cell density (ECD) after phacoemulsification in PEX versus non-PEX eyes.
  • To evaluate the effect of these changes on effective lens position and postoperative refraction.

Main Methods:

  • Prospective case-control study comparing 42 eyes with PEX and 39 eyes without PEX undergoing phacoemulsification.
  • Anterior segment optical coherence tomography measured angle parameters; IOLMaster assessed ACD; specular microscopy measured ECD.
  • Parameters were evaluated at baseline and 2 months postoperatively.

Main Results:

  • Both PEX and non-PEX eyes showed significant increases in angle parameters and ACD post-surgery, with no significant inter-group difference.
  • Anterior chamber depth increase was greater in PEX eyes (P = .017).
  • A hyperopic shift was observed in the PEX group (P = .039), while IOP and ECD decreased similarly in both groups.

Conclusions:

  • Pseudoexfoliation syndrome eyes exhibit greater anterior chamber deepening and a hyperopic shift post-phacoemulsification compared to non-PEX eyes.
  • Zonular laxity in PEX eyes may contribute to these changes.
  • Modified target refraction may be necessary for PEX eyes to achieve desired refractive outcomes after cataract surgery.