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L. R. Fuchs, M. S. Goldfarb, A. H. Friedman; The Presence of Pseudoexfoliation Deposits on Intraocular Lenses. Invest. Ophthalmol. Vis. Sci. 2008;49(13):405.
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© ARVO (1962-2015); The Authors (2016-present)
To report the presence of pseudoexfoliation deposits on intraocular lenses
Charts of patients with PEX deposits on IOLs were reviewed. Subjects had previously been examined routinely under a slit lamp with pupillary dilation, when possible. The date of first visualization and locations of PEX deposits were recorded, as well as dates of cataract extraction and IOL implantation. The location and type of IOL was noted, as was the presence any ocular and systemic diseases.
Twenty-one patients were noted to have PEX deposits on IOLs, 18 of which were female and three were male. The average age at diagnosis of PEX was 77.4 years. There were a total of three anterior chamber (AC) IOLs and 37 posterior chamber (PC) IOLs. Two eyes were phakic. The IOL were composed of the following materials: hydrophobic acrylic, hydrophilic acrylic, polymethylmethacrylate (PMMA), and silicone. All IOLs were PC, except for three PMMA lenses, which were located in the AC. Nineteen of the 21 patients had undergone pupillary dilation at time of deposit visualization. Eight patients had bilateral deposits on IOLs. The most common systemic diseases included arthritis, hypertension and hypercholesterolemia. Two patients had Parkinson’s disease. Six subjects had open-angle glaucoma and two were glaucoma suspects. One patient had bilateral primary intraocular lymphoma and another had unilateral age related macular degeneration in an eye with PEX deposits on the IOL.
In this study, visualization of PEX material on IOLs was seen in a larger sample size than previously reported. Deposits were seen on the anterior surface of both AC and PC IOLs. Different IOL materials are represented in this study, proving that PEX deposits can accumulate on different lens materials. Due to the numerous ocular sequelae that can result in patients with PEX syndrome, careful slit lamp examination and follow-up of patients with visible deposits is needed. As PEX syndrome has been shown to be related to other vascular diseases, patients with evidence of ocular pseudoexfoliation must be monitored for evidence of other systemic diseases. Further research is needed to elucidate these associations.
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