Abstract:
Background: Pseudoexfoliation syndrome [PEX] is characterized by a powdery substance in
the anterior chamber, composed of various glycoproteins, which have an unclear origin. Its
deposition is observed on the pupillary margin, lens zonules, and trabecular meshwork.
Proteomic studies have identified numerous proteins in affected individuals, suggesting
associations with systemic conditions like heart disease, stroke, and Alzheimer’s disease.
However, the systemic associations of PEX remain inconclusive, particularly in regions like
southern India.
Materials and Methods: A cross-sectional study was conducted on 114 participants.
Pseudoexfoliation was graded as mild, moderate and severe per a standard photographic
grading. Systemic examinations included blood pressure measurements, electrocardiography,
and blood investigations for serum lipid profile, fasting and postprandial blood sugar levels,
and serum C-reactive protein levels. All the patients underwent small incision cataract surgery.
Intraoperative complications and postoperative status were noted down.
Results: Thirty-eight patients (33.3%) had mild PEX, 44 (38.6%) had moderate PEX, and 32
(28.1%) had severe PEX. Hypertension was present in 54 participants (47.4%), diabetes in 21
(18.4%), coronary artery disease in 9 (7.9%), and cerebrovascular accidents in 3 (2.6%). The
mean systolic blood pressure was 140.39 mmHg, and the mean diastolic blood pressure was
90.37 mmHg. Systolic blood pressure exceeded 140 mmHg in 29 participants (90.6%) with
severe PEX, while diastolic blood pressure surpassed 90 mmHg in 26 (81.3%) participants with
severe PEX, with a p-value of 0.001. Mean fasting and postprandial blood sugar levels were
103.80 ± 31.81 mg/dl and 131.72 ± 48.24 mg/dl, respectively. Electrocardiographic results
indicated that 54 participants (47.37%) had abnormal ECGs, including rate, conduction, ischemic, and structural defects. Of these, 13.2% had rate defects, 12.3% had conduction
defects, 10.5% had ischemic changes, and 11.4% had structural defects.
Conclusion: This study highlights the significantly elevated parameters of systemic vascular
diseases in PEX patients, like elevated blood pressure and more frequent cardiac abnormalities,
emphasizing the need for comprehensive systemic evaluation and careful preoperative
assessments for ocular complications
