In the eye, PEX syndrome manifests as the presence of pseudoexfoliative material deposits on the anterior lens capsule, ciliary body, zonules
, pupillary edge, corneal endothelium, anterior vitreous, trabeculum and connective tissue in the eyeball (4-7).
However, this surgery has challenging features, which include poor pupillary dilatation caused by the postoperative inflammation, more mobility of the posterior capsule due to the absence of the vitreous, loose zonules
and pre-existing posterior capsular dehiscence associated with lengthy vitreoretinal surgery, multiple procedures, and vitrectomy involving vitreous base dissection.5,12 Thus, the surgery for post-vitrectomy cataract may have more difficulties and higher probability of complications.13 In this study, we improved the traditional surgery by performing phacoemulsification outside the capsule to treat the cataract after vitrectomy and achieved good surgical results.
could not be visualized in the same location (Figure 1b).
(4) This may be due to reduced accommodation with age, or changes in lens size keeping the iris out of contact with the zonules
. (5) As well as tending to occur in this age-range, PDS has preponderance to males more than females.
The material gets deposited on most of the anterior segment structures, including, cornea, iris, ciliary body, lens capsule, zonules
When this PXE material gets clogged in the eye's drainage system, the ocular pressure can rise and lead to glaucoma, and also if the material gets deposited on the structures like zonules
, which hold the lens in place, and are weaker, it would increase the risk of complications during cataract surgery.
PXF has also been known to cause a weakening of lens zonules
leading to lens drop and other complications during cataract surgery.
With ciliochoroidal effusion and anterior rotation of the ciliary body, the iris-lens diaphragm moves forward, the zonules
relax, and the lens thickens, which results in myopic shift and narrowing or closure of the anterior chamber angle [1,4].
The filling of the anterior chamber with OVD should be repeated, and the rhexis should be done with a sharp needle or forceps very slowly and carefully to generate as less pressure to the zonules
Pigment dispersion syndrome (PDS) results from posterior bowing of the iris and rubbing between the lens zonules
and epithelial layer of the iris, and usually affects myopic eyes in men during the third to fourth decade of life.[sup],,,,,,,,,, The literature indicated that Caucasians have the highest prevalence of PDS among all races,[sup] with clinical characteristics including Krukenberg spindle, homogeneous trabecular meshwork (TM) pigmentation, and spoke-like mid-peripheral iris transillumination defects (ITDs), which are referred as a triad of PDS.
Part 5, on primary IOL implantation with compromised capsules, contains three subsections on recommendations for broken capsule with intact zonules
, compromised zonules
and/or lack of capsular support, and managing iris abnormalities combined with IOL fixation.
According to the pamphlet, "The abnormal protein seen in this condition settles and weakens the lens zonules
, which are suspensory fibers that hold the lens in place.