[The effect of the pseudoexfoliative syndrome on the evolution and treatment of pseudoexfoliative glaucoma and senile cataract].

PURPOSE The natural course of pseudoexfoliative syndrome (PES), its influence on the progression and treatment of pseudoexfoliative glaucoma (PEG) and senile cataract. METHODS 28 cases of PES followed up for 10 years were subjected to complete examination including IPT (intraocular pressure tolerance) and AGF (aggressive glaucomatous factor = IPT-IOP determinations). RESULTS 1) The isolated form of PES shows a tendency towards bilateralization in 38% of the cases; 2) the occurrence of open angle glaucoma in 20% of the initially isolated PES cases with a rapid progression of papilloperimetric damage; 3) poorer postoperative results in PEG and PES-associated cataract as compared to those obtained in open angle glaucoma and senile cataract; the high incidence of pre- and postoperative complications (fibrous exudate in aqueous humor, ruptured posterior capsule and vitreous loss respectively). CONCLUSIONS 1) PES is a risk factor in the evolution and treatment of PEG and cataract; 2) the necessity for a more aggressive management in PEG given the rapid alterations of papilloperimetric parameters: 3) poorer functional outcome and increase incidence of pre- and postoperative complications following surgery for PEG and senile cataract.