Centration and fixation of posterior chamber intraocular lenses in eyes with pseudoexfoliation syndrome. An analysis of explanted autopsy eyes.

Pseudoexfoliation syndrome is an important risk factor in cataract surgery. We examined decentration of posterior chamber intraocular lenses in a series of 24 autopsy eyes with pseudoexfoliation syndrome that had undergone cataract surgery and intraocular lens implantation. The results were compared to a control group of 25 normal autopsy eyes that matched the pseudoexfoliation collection for age distribution, implant duration and further anatomical parameters. The mean lens decentration in all pseudoexfoliation eyes (0.75 +/- 0.38 mm) was significantly higher than in the control group (0.40 +/- 0.29 mm) (p = 0.0008). Analysis of subgroups with symmetrical bag/bag fixated intraocular lenses showed a significantly higher decentration in the pseudoexfoliation group (p = 0.04). The main reason for decentration was a decentration of the entire capsular bag in pseudoexfoliative eyes (p = 0.001), which was related to zonular weakness and damage. The results indicate that in patients with pseudoexfoliation syndrome alternative fixation sites, like sulcus or transscleral fixation, should also be considered.