Hyperopic shift, anterior chamber deepening more likely in eyes with pseudoexfoliation
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Eyes with pseudoexfoliation syndrome were more likely to demonstrate a hyperopic shift and greater anterior chamber deepening after phacoemulsification compared with eyes without pseudoexfoliation, according to a study.
“Eyes with cataract and pseudoexfoliation behave differently to those with cataract without PEX not only preoperatively (possible poor mydriasis and phacodonesis in PEX) and intraoperatively (higher rate of complications in PEX) but also postoperatively,” study author Eleftherios Anastasopoulos MD, PhD, told Healio/OSN. “Postoperative refraction surprises should be expected in eyes with PEX. According to the results of the present study, a hyperopic shift from the target refraction is more likely in eyes with PEX.”
In the prospective case-control study, Anastasopoulos and colleagues measured angle opening distance, trabecular-iris space area, scleral spur angle width, anterior chamber depth and endothelial cell density at baseline and 2 months after phaco in 42 eyes with pseudoexfoliation (PEX) and 39 eyes without PEX.
Anterior chamber depth and all angle parameters increased after phacoemulsification in both groups (P < .001), with no significant difference between the groups. The percentile change in anterior chamber depth was greater in eyes with PEX (39.51% ± 16.11%) compared with eyes without PEX (31.5% ± 13.25%) (P = .017). IOP and endothelial cell density decreased postoperatively in both groups, with no statistically significant difference between the groups.
The findings suggest a statistically significant trend toward a hyperopic shift in eyes with PEX (P = .039), which may have “contributed to the zonular instability in those eyes,” according to Anastasopoulos.
“If this finding is verified in additional studies, then ophthalmologists should modify the target refraction toward a more myopic final refraction in eyes with PEX and cataract,” he said.
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