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M.D. Reed, R. Thaker, S. Guo; Ultrasound Biomicroscopic Changes of the Anterior Lens Capsule and Lens Zonule in Patients with Pseudoexfoliation . Invest. Ophthalmol. Vis. Sci. 2003;44(13):200.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the anatomical changes in the lens capsule and lens zonule in patients with pseudoexfoliation (PXF) and occult PXF prior to cataract surgery. Methods: Ultrasound biomicroscope (UBM) model 840 with high frequency ultrasound waves produced real time two-dimensional images of the anterior segment using conventional scleral cup and standard 50 MHz transducer. The anterior lens capsule was measured in five locations in each eye: centrally and in the peripheral lens capsule superiorly, inferiorly, nasally and temporally. Four measurements were taken from the zonule at the thickest point on each fiber. UBM also revealed the presence or absence of nodular deposits on the zonule. Five subjects with a total of nine eyes were studied. Three patients had PXF diagnosed clinically by the presence of fibrillin deposits on the anterior lens capsule, lack of pigment at the papillary ruff and poor pharmacologic dilation. Two subjects without PXF syndrome were used as controls. Results: Mean thickness of the anterior lens capsule centrally was 8.1µm in controls and 13.9µm in patients with PXF. Mean thickness of the anterior lens capsule peripherally was 7.6µm in controls and 13.3µm in PXF patients. Mean zonular thickness was 6.8µm in controls and 10.8µm in PXF patients. No nodular deposits were detected on the zonules of normal patients while all patients with PXF had nodular deposits, mean size of which was 11.0µm (range 4.1um - 28.9um). Conclusion: UBM demonstrated that patients with PXF tended to have thicker and more irregular anterior lens capsules and zonules than controls. Lens zonules of all patients with PXF also showed nodular deposits that were absent in controls. These anatomical differences could help to identify patients at risk for complications of cataract surgery, particularly patients with occult PXF in whom the diagnosis is uncertain prior to surgery.
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