[Centering the posterior chamber lens in autopsy eyes with and without pseudoexfoliation syndrome]

The pseudoexfoliation syndrome (PEX) is an important risk factor for cataract surgery. In this study we examined a series of 24 autopsy eyes with PEX that had undergone cataract surgery and intraocular lens (IOL) implantation. The eyes were grossed for IOL fixation and centration. The results were compared to a control group of 25 non-PEX autopsy eyes that matched the PEX series in age distribution, implant duration and anatomical parameters (i.e., axial length) (P > 0.18). The mean IOL decentration in all PEX eyes (0.75 +/- 0.38 mm) was significantly higher than in the control group (0.40 +/- 0.29 mm) (P = 0.0008). Analysis of subgroups with symmetrical bag/bag fixated IOLs also showed significant higher decentration in the PEX group (P = 0.04). The main reason for decentration was decentration of the entire capsular bag in the PEX eyes (0.28 +/- 0.19 vs 0.10 +/- 0.16 in controls; P = 0.001). Patients with PEX showed a higher amount of IOL decentration. The results indicate that the insufficient suspension apparatus of the lens and decentration of the entire capsular bag are the main reasons for IOL decentration in patients with PEX.