The amount of lens exfoliation and chamber-angle pigmentation in exfoliation syndrome with or without glaucoma.

Correlations of the amount of chamber-angle pigmentation and exfoliation material with IOP and with image analysis of the optic discs are reported in the paired eyes of 63 persons with unilateral exfoliation syndrome, and 35 patients with unilateral capsular glaucoma. The effect on IOP of phenylephrine-induced pigmentary dispersion is examined. Chamber-angle pigmentation was more pronounced in capsular glaucoma than in the nonglaucomatous exfoliation eyes (p < 0.01), although the amount of lens exfoliation was the same. In nonglaucomatous exfoliative eyes IOP correlated significantly with the amount of chamber-angle pigmentation (p < 0.01) and exfoliation material (p < 0.05). The nonglaucomatous exfoliative eyes with grade > or = 2 trabecular pigmentation and those with reduction of IOP on phenylephrine provocation had smaller rim areas and rim/disc area ratios than the fellow eyes (p < 0.05). Rather than the amount of exfoliation, the main risk factor for glaucoma seems to be the degree of chamber-angle pigmentation.