Comparison of findings after dilation between eyes with pseudoexfoliation and normal eyes Findings Eyes with Normal PEX (n=34) eyes Dispersion following pupil 20 14 dilation Homogeneous film on 30 0 the surface of the anterior lens capsule Poor mydriasis Grade 0 10 32 1 14 1 2 2 1 3 0 0 PEX on the surface of 34 0 the anterior lens capsule Bull's eye sign 31 0 PEX on the peripheral 32 0 surface of the anterior lens capsule PEX on the zonules 8 0 Phacodonesis
2 0 Tilted lens 1 0 Central corneal thickness 548.
A significant zonular instability can cause phacodonesis, (7) spontaneous subluxation of the lens8 (Fig.
If obvious phacodonesis is present, then it is advisable to insert a CTR on completing the capsulorhexis to stabilize the capsular bag for phacoemulsification and cortical removal.
Neither iridodonesis nor phacodonesis
As a result, postoperative pseudo phacodonesis
can lead to pigment dispersion and chronic inflammation.
3,4,5,6,7,8) Previous studies showed that zonular weakness with subsequent phacodonesis
in PEX syndrome could lead to anterior lens movement, increased lens thickness (LT) and shallow anterior chamber.
33%) Table 8: Slit lamp examination SLE FINDINGS NO OF PATIENT Immature cataract 19 Traumatic mydriasis / Pupillary abnormality 32 Hyphaema 12 Phacodonesis
08 Pseudophakia 04 Shallow/flat Anterior chamber 10 Tobacco dusting 04 Mature cataract 06 Subconjunctival hemorrhage 05 Anterior chamber reaction 03 Posterior synechia 04 Lens dislocation in vitreous 13 Lens dislocation in Anterior Chamber 06 Iridodialysis 05 Ruptured lens capsule/ Lens Matter in AC 05 Pigment dispersion 07 Corneal edema 32 Vitreous in Anterior Chamber 14 Table 9 : Visual acuity VISION At Follow-up presentation < 1 wk.
There may be no clinical signs in the anterior segment, although a history of ocular trauma may be corroborated by pupillary sphincter ruptures, lens subluxation, or phacodonesis
22) It may be indicated by the presence of a subluxated lens, phacodonesis
(increased mobility of the lens) or iridodonesis (increased mobility or tremulousness of the iris).