Spontaneous Dislocation of the Lens in Pseudoexfoliation Syndrome

Pseudoexfoliation (PSX) syndrome is an acknowledged risk factor in extracapsular cataract surgery 1 and frequently is associated with secondary open-angle glaucoma. Careful slit-lamp microscopic examination reveals discrete phacodonesis in many patients with PSX. 2 We describe two patients with PSX and spontaneous dislocation of the lens into the vitreous. Report of Cases. Case 1. An 87-year-old white man presented in February 1991 for luxation of the lens of his left eye. The patient denied experiencing any direct ocular trauma. Corrected visual acuity was 20/125 OD and 20/400 OS. The intraocular pressure was 16 mm Hg in the right eye and 10 mm Hg in the left. Pseudoexfoliation material was visible bilaterally at the pupillary margin. The left lens was markedly subluxated, and the lens equator and the curled zonular fibers were loaded with PSX material, which was visible behind the dilated pupil ( Figure ). The optic disc showed no glaucomatous changes,