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Background: Pseudoexfoliation (PEX) syndrome, an age related microfibrillopathy having varied prevalence and associated with dense cataract, poorly dilating pupil resulting in challenging cataract surgeries. The present study aimed to evaluate pseudoexfoliation syndrome in eyes undergoing cataract surgery in tertiary care centre of Uttarakhand. Materials and methods: A hospital based prospective study carried out from January 2021 to June 2022 and approved by the Institutional Ethical Committee. A total of 1000 eyes of 1000 patients to be operated underwent complete ophthalmic evaluation including refraction, tonometry, gonioscopy, slit lamp biomicroscopy for presence of pseudoexfoliation, cataract grading, and fundus examination. Patients with PEX were diagnosed and data analysed. Results: A total of 54 PEX cases were diagnosed with 29 (53.7%) males and 25(46.3%) were females having mean age of 67.48 + 9.79 years, mean CCT was 528.46 + 18.49 micron and mean IOP was 19.81 + 5.88 mmHg. Prior to cataract surgery, an IOP of more than 21 mm Hg was noted in 40.7% (n=54) of pseudoexfoliative eyes. PXM on pupillary margin present in 51 (94.4%), on anterior lens capsule in 37 (68.5%), on iris in 31 (57.4%), on cornea in 5 (9.3%), phacodonesis in 6 (11.1%), Iris transillumination defect in 3 (5.6%), PXM on trabecular meshwork in 24 (44.4%) and sampaolesi line in 13 (24.1%). Conclusion: PEX presents challenges that necessitate thorough preoperative planning for a safe surgery and a satisfactory postoperative result. Therefore, dilated anterior segment evaluation should be emphasised in daily practise to avoid early PEX patients from being undiagnosed

Purpose: To evaluate the 3‐year treatment outcomes of XEN 45 gel stent in open‐angle glaucoma patients. Methods: In this prospective, single‐centre interventional study, consecutive eyes with uncontrolled intraocular pressure (IOP) or signs of disease progression despite medical treatment underwent XEN implantation either alone or combined with phacoemulsification (Phaco + XEN). Main outcome measures: Surgical success was defined as 'complete' when 36‐month unmedicated IOP was ≤15 mmHg with a relative IOP reduction ≥ 20% from medicated baseline, while the definition of qualified success allowed no more medications than at baseline. Other definitions of success with different IOP thresholds were also analysed. Secondary outcomes included mean IOP reduction, changes in ocular hypotensive medications and rates of reoperations. Results: Out of 149 eyes initially included, 92 eyes (61.7%) of 68 patients had complete 3‐year data (XEN: n = 26; Phaco + XEN: n = 66) after 38.2% were lost to follow‐up. Mean age was 76.3 ± 9.1 years, and 66.2% were female. Mean medicated IOP decreased from 20.8 ± 7.4 mmHg (21.0 ± 7.4 [XEN] vs. 20.0 ± 6.9 mmHg [Phaco + XEN]) at baseline to 13.1 ± 3.4 mmHg (12.9 ± 2.9 [XEN] vs. 12.9 ± 3.4 [Phaco + XEN]) at 3 years (−37.0%; p < 0.001). Medications decreased from 1.9 ± 1.3 (2.4 ± 1.5 [XEN] vs. 1.9 ± 1.2 [Phaco + XEN]) to 0.4 ± 0.9 (0.3 ± 0.8 [XEN] vs. 0.5 ± 0.9 [Phaco + XEN]) (−78.9%; p < 0.001). Complete success and qualified success were achieved in 29.0% and 31.0% of eyes, respectively. Needling revision was performed in 51 eyes (55.4%), and 26.1% underwent reoperations. Risk factors for surgical failure included male gender (odds ratio [OR]:3.6; p = 0.03), diagnosis of POAG (OR: 4.5; p < 0.01) and undergoing needling revision (OR: 4.6; p < 0.01). While the type of procedure had no effect on the outcomes of PEXG, POAG eyes undergoing combined surgery had significantly higher rates of failure (OR: 7.29; p = 0.023). Most patients stable at 12‐month remained so through to 3 years. Conclusions: At 3 years, XEN gel stent implantation achieved clinically significant IOP and medication reduction despite relatively high rates of needling and reoperations. Identifying patients at risk preoperatively may help optimize surgical outcomes. [ABSTRACT FROM AUTHOR]

In the article the ocular surface was assessed in groups of patients with and without pseudoexfoliative syndrome. Tear secretion (Schirmer test II) and break up time reduction and significant damage of conjunctiva surface (staining with fluorescein) weremarked in group of patients with pseudoexfoliative syndrome. According to questionnaire which reflects index of damage of ocular surface, clinical implications of ocular surface disease was higher in group of patients with pseudoexfoliative syndrome.

Purpose: The goals of this study were to demonstrate the frequency of infrarenal abdominal aortic aneurysm (AAA) in patients with pseudoexfoliation (PEX) syndrome (PEXS) and PEX glaucoma (PEXG), and to determine whether limited screening for AAA in specific subgroups of patients with PEX is reasonable and justifiable. Materials and Methods: This prospective study comprised 60 patients with PEXS and 60 with PEXG (examined group), and 60 patients with primary open-angle glaucoma (POAG) and 60 with cataract (control group). Clinical ophthalmic examination included slit-lamp biomicroscopy of the anterior segment and direct slit-lamp gonioscopy (using a Goldmann three-mirror lens) of the anterior chamber angle. All patients underwent routine Color Doppler duplex ultrasonography of the infrarenal aorta and iliac arteries. Results: There was a statistically significant difference ( p < 0.05) between the PEXG group and control group vis-a-vis presence of AAA, which occurred more frequently in patients with greater amounts of angle pigmentation ( p < 0.05). Univariate logistic regression analysis indicated statistically significant associations between AAA and PEX ( p < 0.01), angle pigmentation ( p < 0.05), gender ( p < 0.01), diabetes mellitus (DM) ( p < 0.05), and arterial hypertension (AHT) ( p < 0.01). Multivariate regression analysis, adjusted to gender and age, showed that the most important clinical parameters related to AAA in patients with PEXS and PEXG are gender, presence of PEX, DM, and AHT ( p < 0.05). Conclusion: The frequency of AAA is significantly higher in patients with PEXS and PEXG than in patients with POAG or cataract. Restricted screening for AAA in male PEXS patients, who also have elevated degrees of angle pigmentation, arterial hypertension, and DM, is clinically warranted. [ABSTRACT FROM AUTHOR]