RESEARCH – October 2004

Exfoliation syndrome and intraocular pressure in patients scheduled for cataract surgery


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The purpose of the study was to examine intraocular pressure (IOP) in patients scheduled for cataract surgery. The series consisted of both the eye to be operated and the other eye. IOP was measured with the Goldmann applanation tonometer before and after mydriasis performed with 1% cyclopentolate and 10% phenylephrine hydrochloride. The diagnosis of exfoliation syndrome was made and a type of cataract was established 40 minutes after mydriasis by slit-lamp examination. The type of lens opacity was recorded as nuclear, cortical, subcapsular or mixed. The presence of prior glaucoma and intraocular surgery was registered.

IOP was higher in the eyes with EXS than in the eyes without EXS and it remained higher after mydriasis in both the eye to be operated and in the contralateral eye. Forty-nine (16.1%) patients had glaucoma, 45 patents had glaucoma in the eye to be operated and 25 patients had glaucoma in both eyes. Four patients had glaucoma only in the other eye. The ratio of exfoliative to primary open-angle glaucoma was 54.4% to 43.6%, respectively. Ocular hypertension (OHT) was found in 58 (9.5%) eyes. In four OHT-patients IOP was higher than 30 mm Hg. IOP was significantly higher in the eyes with glaucoma. Trabeculectomy was made in 22 eyes of 19 patients, while in 9 (41%) eyes IOP was satisfactorily low without medication. Of the glaucoma patients 85.7%, to whom medication was prescribed, received monotherapy. None of the patients had passed laser trabeculoplasty. Mydriasis was significantly smaller in the eyes with EXS. The type of cataract does not affect IOP.