The biometric changes in eyes with pseudoexfoliation syndrome

Purpose: To investigate the biometric changes in eyes with pseudoexfoliation syndrome (PES) in comparison to healthy control eyes with and without pupillary dilatation using phenylephrine topical drops.Material and Methods: Fifty eyes of 50 patients with PES whose pseudoexfoliative material was clearly visible without pupillary dilatation were included in the study. Also 50 eyes of 50 healthy subjects in which pseudoexfoliative material was not seen in routine ophthalmologic examination were included as control group. A-mode ultrasonographic biometry was performed to the patients in supine and upright positions under topical anesthesia.Ultrasonographic measurements were performed 3 times in both positions and they were repeated after phenylephrine topical drops. The median of the biometric measurements were compared.Results: There were 27 male (%54.00) and 23 (%46.00) female in PES group, 19 male (%38.00) and 31 female (%62.00) in the control group.The mean age was 69.08±5.58 (60-80) years in the PES group, 67.44±3.93 (59-77) years in the control group. There was no significant difference between two groups according to age (p=0.093). the mean anterior chamber depth (ACD) in upright position before the pupillary dilatation was 2.93±0.28 mm in PES group, while it was 3.24±0.26mm in supine position. ACD was found to be flat in both positions in PES group and this was statistically significant (upright p=0.0001, supine p=0.0001). ACD deepening in supin position was significant in both groups. (PES p=0.0001, control p=0.0001). There was no difference between the two groups according to the axial length (AL) and lens thickness (LT). The values were both same before and after the pupillary dilatation.Conclusion: ACD is found to be flat especially in the PES group. The changes in the measured values according to the head positions were found to be same with the control group. The pupillary dilatation does not affect the biometric measurements. The zonular weakness in particularly pseudoexfoliative eyes causes complications in ophthalmic surgery. We think that the ACD flatness in pseudoexfoliative eyes which our study reveals will increase the complication rate. The facts that pupillary dilatation does not affect biometric measurements and that the ACD values before the operation can be maintained during the operation, reveal that intraoperative complication risk might decrease.Key Words: Pseudoexfoliation, A-scan biometry, phenylephrine.