Intraocular lens implantation in exfoliation syndrome and capsular glaucoma

The intra-operative difficulties and post-operative complications after posterior chamber lens implantation are described in 30 eyes with exfoliation syndrome (including 19 eyes with capsular glaucoma (CG), 30 age- and sex-matched patients with non-exfoliative eyes comprised a comparison group. Three eyes of the control group had simple glaucoma. The highest risk rate for intra-operative difficulties and post-operative complications was found in the CG group. 8/19 eyes had intra-operative difficulties and 7/19 post-operative complications corresponding 3/11 eyes and 2/11 eyes, respectively, in the exfoliation (E) group. Eyes in the control group had a low rate of complications, 3/30 intra-operatively and 2/30 post-operatively. In 63% of the CG and E eyes the visual acuity was 0.5-1.0 1 month post-operatively compared with 70% in the control group. Exfoliation syndrome is not a contraindication for posterior chamber lens implantation. Special attention should be paid to IOL selection. Complications due to insufficient mydriasis, weak zonules and possible undiagnosed lens subluxation, should be taken into account on planning the operation.