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   Table of Contents      
Year : 2016  |  Volume : 64  |  Issue : 12  |  Page : 949

Pseudoexfoliation on pseudophakos

Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Talhati, Rajasthan, India

Date of Web Publication23-Jan-2017

Correspondence Address:
Amit Mohan
Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Abu Road, Talhati, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.198859

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How to cite this article:
Mohan A. Pseudoexfoliation on pseudophakos. Indian J Ophthalmol 2016;64:949

How to cite this URL:
Mohan A. Pseudoexfoliation on pseudophakos. Indian J Ophthalmol [serial online] 2016 [cited 2020 Oct 29];64:949. Available from: https://www.ijo.in/text.asp?2016/64/12/949/198859


We read the brief communication titled “Pseudoexfoliation on pseudophakos” with interest.[1] Authors have reported three cases of pseudoexfoliation (PXF) on polymethylmethacrylate (PMMA) intraocular lenses (IOLs), all implanted in the sulcus. They have supported the hypothesis given by Park and Kee that IOL placed in sulcus stimulates the production of PXF by the ciliary body.[2]

Contrary to these findings, we have a similar case of PXF on the anterior and posterior surface of PMMA IOL which was well placed in capsular bag [Figure 1]. PXF was dense, involving visual axis, and was distributed as pattern striations originating from periphery on anterior surface and as multiple granular spots on the posterior surface of IOL [Figure 2]. The patient was 68-year-old, cattle breeder by occupation, spending most of the time outdoors, and was operated for nuclear cataract as small incision cataract surgery with PMMA IOL implantation in capsular bag 6 years back in our center, and PXF was not observed in either eye at that time.
Figure 1: Linear striations of pseudoexfoliation material on anterior surface of intraocular lens implanted in the bag

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Figure 2: Granular deposit of pseudoexfoliation on posterior surface of polymethylmethacrylate lens

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This PXF material may be produced by equatorial lens capsule and deposited on IOLs in the bag.[3] Duration of outdoor activity exposing the individual for ultraviolet and infrared rays as well as IOL surface irregularities [4] may aggravate the deposition of PXF in such cases. In largest published series till date, da Rocha-Bastos et al. had reported seven such cases out of which six patients had in the bag implantation.[5]

Pathophysiology and clinical significance of this finding remain unknown, but careful follow-up of suspected PXF syndrome is essential even in pseudophakos since PXF material deposits even over IOLs and lead to glaucoma.

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There are no conflicts of interest.

  References Top

Kaliaperumal S, Rao VA, Harish SB, Ashok L. Pseudoexfoliation on pseudophakos. Indian J Ophthalmol 2013;61:359-61.  Back to cited text no. 1
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Park KA, Kee C. Pseudoexfoliative material on the IOL surface and development of glaucoma after cataract surgery in patients with pseudoexfoliation syndrome. J Cataract Refract Surg 2007;33:1815-8.  Back to cited text no. 2
Hietanen J. Origin of exfoliation material. In: Hollo G, Konstas AG, editors. Exfoliation Syndrome and Exfoliative Glaucoma. Savona, Italy: Dogma; 2008. p. 57-66.  Back to cited text no. 3
Lombardo M, De Santo MP, Lombardo G, Barberi R, Serrao S. Analysis of intraocular lens surface properties with atomic force microscopy. J Cataract Refract Surg 2006;32:1378-84.  Back to cited text no. 4
da Rocha-Bastos RA, Silva SE, Prézia F, Falcão-Reis F, Melo AB. Pseudoexfoliation material on posterior chamber intraocular lenses. Clin Ophthalmol 2014;8:1475-8.  Back to cited text no. 5


  [Figure 1], [Figure 2]


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