Abstract
Purpose:
As primary objective, to assess the prevalence of pseudoexfoliation (PXF) among patients scheduled for cataract surgery at our institution. As secondary objectives, to assess whether PXF is associated with the hardness of lens nucleus, pupil dilation, glaucoma and age.
Methods:
A cross-sectional prevalence study was designed. We evaluated 1763 phakic eyes of 1093 patients scheduled for cataract surgery between January 2013 and August 2013. All patients underwent a complete ophthalmological examination performed by an experienced cataract surgeon. PXF was diagnosed in phakic eyes that showed characteristic central and/or peripheral whitish deposits on the lens surface. Pupils were evaluated with a portable pupil chart after dilatation with topical tropicamide. Nucleus hardness was assessed according to the Lens Opacities Classification System (LOCS) III. IOP was measured with Perkins tonometry. Diagnosis of glaucoma was based on Foster’s criteria for prevalence studies.
Results:
A total of 381 eyes (21.6%) were diagnosed with PXF. Prevalence of PXF increased significantly with age: 1% in people younger than 50 years, 3.1% in those between 50 and 60 years, 14.3% in those between 60 and 70 years, 40.1% in those between 70 and 80 years and 41.6% in those older than 80 years. In PXF eyes, nuclear cataracts were significantly harder compared with non-PXF eyes (p<0.001). Mean IOP was higher in PXF eyes (16.51±2.81mmHg) compared to non-PXF eyes (16.06±2 mmHg) with a statistical significant difference (p=0.002). Prevalence of glaucoma was higher in PXF eyes (35.1%) compared to non-PXF eyes (9.6%) with a statistically significant difference (p<0.001). In PXF eyes, pupil size was significantly smaller compared to non-PXF eyes (p<0.001). These results remained significant after age adjustment.
Conclusions:
In the population under study prevalence of PXF was high and increased significantly with age. PXF eyes were associated with harder nuclear cataracts compared to non-PXF eyes, with a statistically significant difference (p<0.001). This association persisted after adjustment for age. Independently of age, cataract development may increase in PXF patients. PXF was also significantly associated with glaucoma, rise in IOP and poor pupil dilation.
Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence •
421 anterior segment •
445 cataract