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    Cataract surgery for patients with PXF

    They are more likely to experience tear function disorders

    I am fortunate to be able to share stories about my mother. Many of my article topics have been inspired by experiences and thoughts shared with my mom.

    For background, my mother is 79 years old and, except for a bum knee, is in excellent health. She also is very smart, and sassy, having earned a PhD in organic chemistry decades ago.

    Mom is a tough old bird whose career included teaching grade school science to performing histocompatability research at Memorial Sloan Kettering Cancer Center in New York. She has a unique perspectives and interests in topics from community gardening to urban planning.

    Mom has pseudoexfoliation syndrome (PXF) clinically visible in both eyes. She experiences pops of elevated intraocular pressure (IOP) in one eye and uses glaucoma medications.

    Previously from Dr. Mastrota: How sick building syndrome symptoms can mimic dry eye

    We decided that it was in her best interest to proceed with cataract surgery because she was experiencing difficulty traveling home at night from local community board meetings.

    Pre-surgery preparations

    Pre-surgery presented a question-and-answer period that included lecture-quality review of the ocular manifestations and potential surgical complications of cataract surgery—especially in patients with PXF. After the pre-surgery preparations, Mom hesitantly agreed to proceed with surgery.

    Although PXF is considered a systemic condition,1 its clinical signs are mostly identified in the eye. Most practitioners are familiar with the grey-white material that is deposited on the anterior structures, notably the anterior lens capsule.

    This material, consisting of nanometer-sized fibrils within a loose matrix, is generated multifocally within the eye. The fibrils in PXF are thought to be generated by polymorphisms in a gene named LOXL-1(lysyl oxidase like 1) that is responsible for the biogenesis of connective tissue.2

    Related: Complementary and alternative medicine help dry eye patients

    One must recognize that the aberrant material deposited in PXF impacts many structures of the eye and may compromise its proper function.

    Katherine M. Mastrota, MS, OD, FAAO
    Clinical director of Omni Center for Dry Eye Specialty Care in New York City

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