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[Combined true exfoliation and pseudoexfoliation of the anterior lens capsule]
M Küchle1, W J Iliff, W R Green
1Eye Pathology Laboratory, Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Background:
True exfoliation of the lens capsule is rare, and its occurrence with pseudoexfoliation in the same eye is very unusual.
Case Report:
An 81-year-old female presented with bilateral cataracts and a history of working with ceramics in her home kiln. Slit-lamp examination revealed pseudoexfoliation. She underwent intracapsular cataract extraction and sector iridectomy in both eyes. Light and electron microscopy of the lenses revealed a central area of splitting of the anterior lens capsule into a thin anterior and a thicker posterior layer, and deposits pseudoexfoliation material on the anterior lens capsule, on the iris pigment epithelium, and in the iris stroma.
Conclusions:
We interpret our findings as representing a combination of true exfoliation and pseudoexfoliation, but we did not observe any signs that might indicate a correlation or a common pathogenesis of the two conditions. Although they may occur in one eye, true exfoliation of the lens capsule and pseudoexfoliation are two unrelated distinct entities.