Surgeon must be aware of the following factors before taking on surgery in such compromised eyes: conjunctival scarring, low endothelial cell counts, poor pupillary dilatation, increased lens-iris diaphragm retropulsion,
zonular weakness and pre-existing posterior capsular damage as well as diabetic retinopathy, low scleral rigidity, cystoid macular edema and other co-morbidities.
Pathologic production and deposition of PEX material has been associated with development of intraocular complications (corneal endotheliopathy, iridopathy with reduced pupillary opening, ciliary body alterations, instability and degenerative changes of
zonular apparatus, increased lens mobility, lens or intraocular graft decentration and dislocation, pigment dispersion, secondary open-angle and angle-closure glaucoma, pseudouveitis, anterior synechiae, and anterior chamber hypoxia).
Dislocated Intraocular lens (IOL) might be presented during or after cataract surgery, trauma, insufficient capsular support, or
zonular dehiscence (1).
Asymmetrical rhexis, especially in mature cataracts and hyper mature cataracts, deformed haptics and
zonular weakness causes IOL decentration [21].
The words "
zonular", which was worth 100 points and means "like a zone", and "phenolic", which scored 84 points and means "a synthetic resin" were among the highest-scoring words in the final.
The high incidence of narrow angle configuration observed in patients with pseudoexfoliation may be associated with increased iris thickness, posterior synechiae, and
zonular weakness.
People with PXS are susceptible to open angle glaucoma and complications during cataract surgery including post-operative corneal edema, intraocular pressure elevation, lens subluxation,
zonular dehiscence, poorly dilating pupil and posterior capsular rupture.
(2) Although the lenticular theories propose age-related changes to the lens, capsule, and
zonular fibres, the extralenticular mechanism includes ciliary muscle dysfunction, loss of elasticity in the posterior
zonular fibres, and even decreased resistance of the vitreous against the lens capsule.
There are different factors that could influence the level of ACO, such as CCC's initial size; IOL material and design; and some preexisting conditions (e.g., the quality of the
zonular support).
Radial tear may in turn lead to a series of complications such as the
zonular rupture, posterior capsule tear, and vitreous presentation, insufficient capsular support for the IOL implantation or even nucleus drop during phacoemulsification.
Pigment accumulated at the
zonular attachments to the lens.
Zonular and lenticular pigmentation on posterior lens surface are also common findings in PDS patients after mydriasis.[sup][8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20]