Optical low-coherence reflectometry enables preoperative detection of zonular weakness in pseudoexfoliation syndrome

Purpose To evaluate optical ocular components in patients with pseudoexfoliation syndrome using optical low-coherence reflectometry. Methods A prospective cohort study of 224 eyes of patients planned for cataract surgery was conducted in the period from January 2009 until July 2009. Patients were divided in two groups: the first group of 47 eyes with cataract complicated with pseudoexfoliation syndrome and the control group of 177 eyes with uncomplicated cataract. Each group was further divided into two subgroups based on its refractive state: emmetropes and hypermetropes. The optical low-coherence reflectometry biometer LENSTAR® LS 900® was used to define ocular optical components. Results A statistically significant difference of ocular optical components was established between the two groups of patients and its matching subgroups: AL ( t = 2.25; p < 0.05) and ACD ( t = 2.24; p < 0.05) were significantly higher in the control group, PD was significantly higher in the control group hypermetropes than the PEX group hypermetropes ( t = 2.21; p < 0.05) while LT ( t = 3.01; p < 0.001), AST ( t = 2.13; p < 0.05) and IOL ( t = 3.06; p < 0.001) were higher in the PEX group of patients than in the control group. Conclusions The optical low-coherence reflectometry enabled preoperative detection of zonular weakness and subsequent lens instability documented as a significantly shallower anterior chamber, thicker lens, and smaller pupillary diameter in the pseudoexfoliation syndrome group in the studied population.