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    Cataract surgery cuts glaucoma risk in eyes with pseudoexfoliation

    Cataract surgery appears to reduce the risk of glaucoma in eyes with pseudoexfoliation (PEX) syndrome, researchers said. 

    “The present study indicates that there should be a rather low threshold for performing cataract extraction in PEX eyes with regard to the risk of developing glaucoma,” wrote Olav Kristianslund, MD, MPh, resident in ophthalmology, PhD-student, and colleagues from Oslo University Hospital and the University of Oslo, Norway.

    They published their findings in Acta Ophthalmologica.

    Related: Ocular insert overcoming glaucoma treatment challenges

    Pseudoexfoliative material apparently clogs the trabecular meshwork, Schlemm’s canal, and collector channels, elevating IOP and making PEX syndrome the greatest risk factor for glaucoma.

    Several studies have shown that cataract surgery lowers IOP in eyes with or without PEX syndrome, the authors reported, but they were unable to find any research comparing glaucoma development after cataract surgery under these two conditions.

    To fill this gap, they analyzed data from patients recruited for previous studies who had cataract surgery between June 2001 and December 2002 at Oslo University Hospital. From 1,193 patients, they found 51 with PEX syndrome who were still living in the Oslo area in 2008 and able to participate. They compared these with 102 controls.

    Related: Taking a closer look at low-tension glaucoma risk factors, treatment guidelines

    Patients in both groups had a mean age of 82.4 years at the time of re-examination and a majority, 72.5%, were female. The mean time from cataract surgery to re-examination was 76 months.

    At baseline, 16 (31%) of the patients with PEX had glaucoma, compared with 10 (19%) of the patients without glaucoma. The mean IOP at baseline was 16.5 mm Hg in the PEX group and 15.7 mm Hg in the control group.

     In each case, surgery consisted of a sutureless small limbal incision, a capsulorrhexis, hydrodissection, and phacoemulsification, followed by the insertion of a foldable IOL using forceps.

    Surgeons placed the IOL in the capsular bag in almost all these patients, except two in the PEX group and 10 in the control group who had the lens placed in the ciliary sulcus.


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