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Abstract：
Background Pseudoexfoliation syndrome (PEX) is characterized by a dandruff-like substance in the anterior chamber, composed of various glycoproteins that have an unclear origin. Its deposition is observed on the pupillary margin, lens zonules, and trabecular meshwork. Proteomic studies have identified numerous proteins in the affected individuals, suggesting associations with systemic conditions like heart disease, stroke, and Alzheimer\'s disease. However, the systemic associations of PEX remain inconclusive, particularly in regions like southern India. Materials and methods A cross-sectional study was conducted on 114 participants. Pseudoexfoliation was graded as mild, moderate, and severe as per standard photographic grading. Systemic examinations included blood pressure measurements, electrocardiography (ECG), and blood investigations for serum lipid profile, fasting and postprandial blood sugar levels, and serum C-reactive protein levels. Small incision cataract surgery was performed for all the patients. Intraoperative complications and postoperative status were recorded. Results Thirty-eight patients (33.3%) had mild PEX, 44 (38.6%) had moderate PEX, and 32 (28.1%) had severe PEX. Hypertension was present in 54 participants (47.4%), diabetes in 21 (18.4%), coronary artery disease in nine (7.9%), and cerebrovascular accidents in three (2.6%). The mean systolic blood pressure was 140.39 mmHg and the mean diastolic blood pressure was 90.37 mmHg. Systolic blood pressure exceeded 140 mmHg in 29 participants (90.6%) with severe PEX, while diastolic blood pressure surpassed 90 mmHg in 26 participants with severe PEX, both with a p-value of 0.001. Mean fasting and postprandial blood sugar levels were 103.80 ± 31.81 mg/dl and 131.72 ± 48.24 mg/dl, respectively. Serum lipid profiles showed mean low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), cholesterol, and triglyceride levels of 103.00 ± 34.49 mg/dl, 29.04 ± 15.51 mg/dl, 172.73 ± 43.34 mg/dl, and 129.33 ± 64.65 mg/dl respectively. Electrocardiographic results indicated that 54 participants (47.37%) had abnormal ECG including rate abnormality in 13.2%, conduction defects in 12.3%, ischemic changes in 10.5%, and structural defects in 11.4%. Eighty-seven percent of patients had non-dilating pupils and iris atrophy, 13.2% had zonular dialysis and intraoperatively, 78% had capsulorhexis extension, 49.12% had difficult nucleus prolapse, and 28.95% had posterior capsular rent. Conclusion This study highlights the significantly elevated parameters of systemic vascular diseases in PEX patients, like elevated blood pressure and more frequent cardiac anomalies, emphasizing the need for comprehensive systemic evaluation and careful preoperative assessment for ocular comorbidities.
摘要：
背景假性剥脱综合征（PEX）的特征是前房中的头皮屑样物质，由起源不清楚的各种糖蛋白组成。在瞳孔边缘观察到它的沉积，晶状体小带,和小梁网.蛋白质组学研究已经在受影响的个体中确定了许多蛋白质，提示与心脏病等系统性疾病有关联，中风,和老年痴呆症。然而,PEX的系统性关联仍然没有定论，特别是在印度南部等地区。材料和方法对114名参与者进行了横断面研究。假性剥脱被分级为轻度，中度,和严重的标准摄影分级。系统检查包括血压测量，心电图(ECG),和血液调查的血清脂质分布，空腹和餐后血糖水平，和血清C反应蛋白水平。所有患者均进行小切口白内障手术。记录术中并发症及术后情况。结果38例(33.3%)患者有轻度PEX,44（38.6%）有中度PEX，32例（28.1%）患有严重PEX。54名参与者出现高血压（47.4%），21例糖尿病（18.4%），9例冠状动脉疾病（7.9％），和脑血管意外的三人(2.6%)。平均收缩压为140.39mmHg，平均舒张压为90.37mmHg。29例重度PEX患者收缩压超过140mmHg（90.6%），26名患有严重PEX的参与者的舒张压超过90mmHg，两者的p值为0.001。平均空腹和餐后血糖水平分别为103.80±31.81mg/dl和131.72±48.24mg/dl，分别。血脂谱显示平均低密度脂蛋白（LDL），极低密度脂蛋白（VLDL），胆固醇,甘油三酯水平为103.00±34.49mg/dl，29.04±15.51mg/dl，172.73±43.34mg/dl，和129.33±64.65mg/dl。心电图结果显示54例（47.37%）患者存在心电图异常，其中发生率异常13.2%，12.3%的传导缺陷，缺血改变10.5%，和结构缺陷11.4%。87%的患者有瞳孔不扩张和虹膜萎缩，13.2％的人进行了带状透析和术中，78%有撕囊延伸，49.12%有困难的核脱垂，28.95%有后囊膜租金。结论本研究强调PEX患者全身血管病变的参数显著升高,比如血压升高和更频繁的心脏异常，强调需要对眼部合并症进行全面的系统评估和仔细的术前评估。
