Pseudoexfoliation syndrome: pathological manifestations of relevance to intraocular surgery

Clinical and Experimental Ophthalmology - Tập 32 Số 2 - Trang 199-210 - 2004
Robert M. Conway1,2, Ursula Schlötzer‐Schrehardt3, Michael Küchle3, Gottfried O.H. Naumann3
1Department of Ophthalmology and Eye Hospital, University of Erlangen-Nürnberg, Erlangen, Germany
2Sydney Eye Hospital and Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
3Department of Ophthalmology and Eye Hospital,University of Erlangen-Nurnberg, Erlangen, Germany

Tóm tắt

AbstractPseudoexfoliation syndrome (PEX) is a common ocular condition often associated with the need for intraocular surgery. Although results of cataract and glaucoma filtering surgery in eyes with PEX in the early stages of the disease may be comparable to those in eyes without PEX, in the later stages morbidity is significantly increased due to periocular surgical complications and the outcome is worse. Surgical and postoperative difficulties are often multifactorial and are directly related to the pathological changes of PEX on intraocular structures. Recent years have seen a large increase in the understanding of the effects of PEX on the various ocular tissues. Although the visible areas of the anterior capsule are most obviously involved, this is only a small part of the picture and of least significance. Biomicroscopically invisible changes of the zonules and their attachments are of greatest consequence. There is also distinct, often active, involvement of almost all tissues of the anterior segment of the eye, many of which have important implications for the anterior segment surgeon including iridopathy, iris vasculopathy (including persistent breakdown of the blood−aqueous barrier and anterior segment hypoxia), ciliary body involvement and keratopathy. Trabecular dysfunction is evident by the deposition of PEX material derived from bothin situand extra‐trabecular production as well as protein and melanin deposition. These changes should be kept in mind by all intraocular surgeons as a source of potential difficulties in the perioperative period. Additionally, in light of these changes, patients need to be given realistic expectations regarding the increased risk of complications and more prolonged expected recovery time. In this short review, current reports relating to PEX pathological changes of practical interest to the intraocular surgeon are summarized.

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Clinical and Experimental Ophthalmology

Tập 32 Số 2

199-210

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