title: Pseudoexfoliation syndrome and secondary cataract.
abstract: OBJECTIVE
  The pseudoexfoliation (PEX) syndrome is frequently associated with impairment of the blood-aqueous barrier. This study analysed if this might stimulate secondary cataract following cataract extraction.
  
  
  METHODS
  This historical cohort study included 197 eyes of 197 patients (99 with and 98 without PEX) that underwent extracapsular cataract extraction with posterior chamber lens implantation (PMMA optic) between 1985 and 1991. Secondary cataract was defined as opacification of the axial posterior capsule and decrease of visual acuity by two or more lines. Mean follow up was 23.8 months. For statistical analysis, the Kaplan-Meier method and multivariate Cox regression analysis were used.
  
  
  RESULTS
  Secondary cataract was observed within 24 months in 35% (SD 7%) of all eyes, and was significantly more frequent in eyes with PEX (45 (11)%) than in eyes without PEX (24 (9)%, p < 0.03). Eyes with diabetes mellitus (n = 32) showed a significantly lower frequency of secondary cataract (11 (11)%) than eyes without diabetes mellitus (39 (8)%, p < 0.01). The influences of sex, open angle glaucoma, type of cataract, surgeon, positioning of IOL, and phacoemulsification versus nuclear expression on secondary cataract did not reach statistical significance.
  
  
  CONCLUSIONS
  The higher frequency of secondary cataract could be considered as another potential complication of cataract surgery in eyes with PEX.
authors.affiliation: University of Erlangen-Nürnberg, Department of Ophthalmology, Erlangen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Küchle
authors.forename: A
authors.initials: A
authors.lastname: Amberg
authors.forename: P
authors.initials: P
authors.lastname: Martus
authors.forename: N X
authors.initials: NX
authors.lastname: Nguyen
authors.forename: G O
authors.initials: GO
authors.lastname: Naumann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002386:Cataract / Q000209:etiology*; D002387:Cataract Extraction; D015331:Cohort Studies; D017889:Exfoliation Syndrome / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012044:Regression Analysis; D012189:Retrospective Studies