title: Electron microscopic investigation of the lens capsule and conjunctival tissues in individuals with clinically unilateral pseudoexfoliation syndrome.
abstract: OBJECTIVE
  To determine the presence of pseudoexfoliative material in the unaffected eyes of patients with clinically unilateral pseudoexfoliation syndrome.
  
  
  METHODS
  Prospective observational case series.
  
  
  METHODS
  Thirty-two consecutive patients with clinically unilateral pseudoexfoliation syndrome, undergoing routine cataract surgery.
  
  
  METHODS
  Transmission electron microscopy (TEM) was used to examine conjunctival and anterior lens capsule specimens in affected and unaffected eyes.
  
  
  METHODS
  Presence of characteristic pseudoexfoliation syndrome findings on TEM.
  
  
  RESULTS
  Transmission electron microscopy demonstrated pseudoexfoliative material on either the anterior capsule or conjunctival sample from the clinically unaffected eye in 26 of the 32 patients with clinically unilateral pseudoexfoliation syndrome (81%; 95% confidence interval, 64%-93%).
  
  
  CONCLUSIONS
  The results suggest that the seemingly uninvolved eye in a patient with clinically unilateral pseudoexfoliation syndrome has an 81% likelihood of being affected ultrastructurally. Several population studies examining conversion rates from unilateral to bilateral disease have found a similar proportion of patients with bilateral pseudoexfoliation syndrome in the later decades of life.
authors: Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-9238, USA.
authors: Parag
authors: P
authors: Parekh
authors: W Richard
authors: WR
authors: Green
authors: Walter J
authors: WJ
authors: Stark
authors: Esen Karamursel
authors: EK
authors: Akpek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000473:pathology*; D017889:Exfoliation Syndrome / Q000473:pathology*; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011446:Prospective Studies