Search

Objectives: The objective of this systematic review and meta-analysis is to evaluate the existing evidence and estimate the impact of phacoemulsification and intraocular lens implantation on the intraocular pressure (IOP) of subjects with exfoliation syndrome (XFS) or exfoliative glaucoma (XFG). Methods: In July 2024, an in-depth literature review across three databases was undertaken. This study focused only on adult patients with exfoliation who had not undergone previous ocular surgery. The primary outcome of interest was the mean IOP reduction at 6 and 12 months after uncomplicated phacoemulsification surgery. Results: This meta-analysis included one randomized controlled trial and eight observational studies, comprising 220 patients at 6 months and 430 patients at the 12-month time point, respectively. The mean IOP reduction after surgery was 3.43 mmHg (95% CI: −4.77 to −2.09) after 6 months and 2.75 mmHg (95% CI: −4.24 to −1.26) after 12 months. In both time points, there was no heterogeneity (I2 = 0), but the certainty of evidence following the GRADE evaluation was very low. Conclusions: The present meta-analysis demonstrates that phacoemulsification can significantly reduce IOP in exfoliation subjects 6 and 12 months after surgery. Nevertheless, significant limitations in included studies do not allow a precise and certain estimate of the magnitude of postoperative IOP lowering in exfoliation patients. Additional research is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy and safety of primary Ahmed valve implantation (AVI) and primary trabeculectomy with mitomycin C (MMC) in patients with pseudophakic exfoliative glaucoma (XFG). Methods: All enrolled patients were divided into two groups: the TRAB group, comprising patients who underwent trabeculectomy with MMC, and the AVI group, comprising patients who underwent AVI. Intraocular pressure (IOP), mean deviation (MD), endothelial cell density of cornea (ECD), and the number of topical anti-glaucoma agents used during study period were retrospectively analyzed. Surgical success rates were compared between two groups using Kaplan–Meier survival analysis. Three levels of surgical success were defined as follows: (1) IOP ≤ 18 mmHg and an IOP reduction of 20% without medication; (2) IOP ≤ 15 mmHg and an IOP reduction of 25% without medication; and (3) IOP ≤ 18 mmHg and an IOP reduction of 20%, irrespective of medication. Results: The TRAB and AVI groups comprised 40 and 36 patients, respectively. At 36 months postoperatively, IOP was 15.7 ± 2.8 mmHg in the TRAB group and 16.9 ± 3.3 mmHg in the AVI group (p = 0.140). Surgical success rates in the TRAB group were 47.5, 37.5, and 77.5% and those in the AVI group were 41.6, 33.3, and 75.0% at 36 months for surgical criteria 1, 2, and 3, respectively. There were no statistically significant differences in the success rates between the two groups. However, regarding surgical criteria 2, the success rate of the AVI group at 1 year was significantly better than that of the TRAB group (p = 0.030). Conclusions: Primary AVI was not inferior to primary trabeculectomy with MMC in medically uncontrolled patients with XFG. [ABSTRACT FROM AUTHOR]

Aims: To compare retinal nerve fiber layer (RNFL) thickness and choroidal thickness in patients with exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) for 1–5 years or 6–10 years compared to healthy volunteers. Methods and Material: Seventy-eight eyes of 78 patients with XFG, 78 eyes of 78 patients with XFS, and 83 eyes of 83 healthy individuals were included in this prospective study. SD-OCT data for choroid thickness and RNFL were recorded. Results: RNFL thickness was statistically significantly lower in eyes with XFG and XFS than in the control group (p < 0.001). Macular choroidal thickness decreased significantly in the XFG group compared to the XFS and control groups (p < 0.001). No significant difference was observed between the XFS and control groups (p > 0.05). In terms of choroidal and RNFL thicknesses by years in XFG and XFS patients, values were lower in the patients diagnosed 6–10 years previously than in those diagnosed 1–5 years previously. However, the difference was not statistically significant (p > 0.05). Conclusions: Thinning of both choroidal and RNLF thickness in XFG and XFS patients may mean that PEX material is an important risk factor for the progression of XFS to XFG. In addition, thinner choroid and RNLF thickness in the 6–10 years groups show the effect of PEX material and the importance of time. [ABSTRACT FROM AUTHOR]

Aims: To compare retinal nerve fiber layer (RNFL) thickness and choroidal thickness in patients with exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) for 1–5 years or 6–10 years compared to healthy volunteers. Methods and Material: Seventy-eight eyes of 78 patients with XFG, 78 eyes of 78 patients with XFS, and 83 eyes of 83 healthy individuals were included in this prospective study. SD-OCT data for choroid thickness and RNFL were recorded. Results: RNFL thickness was statistically significantly lower in eyes with XFG and XFS than in the control group (p < 0.001). Macular choroidal thickness decreased significantly in the XFG group compared to the XFS and control groups (p < 0.001). No significant difference was observed between the XFS and control groups (p > 0.05). In terms of choroidal and RNFL thicknesses by years in XFG and XFS patients, values were lower in the patients diagnosed 6–10 years previously than in those diagnosed 1–5 years previously. However, the difference was not statistically significant (p > 0.05). Conclusions: Thinning of both choroidal and RNLF thickness in XFG and XFS patients may mean that PEX material is an important risk factor for the progression of XFS to XFG. In addition, thinner choroid and RNLF thickness in the 6–10 years groups show the effect of PEX material and the importance of time.

Purpose: This study aimed to assess the possible effect of environmental factors and eating habits on patients with the exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) in a Turkish population., Methods: A questionnaire was applied to 1,000 individuals, including 290 patients with XFS, 210 patients with XFG, and 500 age- and sex-matched healthy control participants. Sociodemographic characteristics, home type and warming methods, living and working conditions (indoor-outdoor), dietary habits based on the the guidance of Turkey Dietary Guidelines, (Determination of Nutritional Status Report and Turkey National Nutrition and Health Survey) and using sunglasses were evaluated. The chi-square test, Student t test, and analysis of variance were used for the statistical analysis with SPSS v. 23.0 software., Results: The case-control groups were matched during data collection, and age and sex distribution in groups was analyzed; however, no difference was found. The average years and hours spent outdoor were statistically different between case and control groups ( P  < 0.05). The disease risk among individuals wearing sunglasses was 2.74 times less than that among those who did not wear sunglasses. Individuals born in the city had 1.46 times lower risk. Also, living out of the city until the age of 12 years increased the risk of getting the disease 1.36 times. In addition, while living in an apartment decreased the risk of disease, using a stove increased. The control groups had more healthy eating habits than the case groups., Conclusion: This case-control study showed that time spent outdoors, wearing sunglasses, home type, heating method, and eating habits might be associated with XFS and XFG., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To compare plasma levels of sirtuin 1 (SIRT1) and adiponectin (APN) in patients with primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG), and healthy control subjects., Methods: This prospective case-control study collected plasma samples from 118 participants. All subjects underwent a comprehensive ophthalmologic examination before the acquisition of a plasma sample. Plasma samples were obtained from 40 POAG, 38 XFG, and 40 healthy control subjects without any evidence of systemic or ocular disease. Serum SIRT1 and APN levels were estimated by an enzyme-linked immunosorbent assay, ELISA (Elabscience, Houston, USA) method. Statistical analysis of results relied on Kolmogorov-Smirnov, Kruskal-Wallis, Chi-square, analysis of variance (ANOVA) tests, and linear regression analysis, where appropriate., Results: A significant decrease in SIRT1 levels was observed in POAG patients compared to healthy controls (p = 0.004, Dunn's test). In contrast, no difference was detected between XFG and POAG patients or healthy controls (p = 0.32 and p = 0.34, respectively, Dunn's test). There was no significant difference in plasma APN levels between the three groups under investigation (p = 0.59, ANOVA)., Conclusion: Alterations in serum level of SIRT1 may suggest a possible role in POAG via potential effects in neuroprotection and oxidative stress.