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Purpose: To investigate the prevalence of glaucoma and coronary artery disease (CAD) in patients with cataract and pseudoexfoliation (PEX) syndrome., Methods: Cross-sectional study of 2140 consecutive patients with cataract admitted at the University Hospital of Patras, Greece, for cataract surgery. Only patients with senile cataract were included in this study. All patients underwent a complete ophthalmological examination that included slit-lamp evaluation with dilated pupil for PEX material in the anterior segment, intraocular pressure (IOP) measurements, and optic disc cup examination. They also underwent an evaluation for CAD by a cardiologist. CAD was considered present if a patient had a history of myocardial infarction, or ischaemia, or abnormal coronary angiography. The patients were classified into two groups: the PEX and the non-PEX group., Results: One thousand and eighty-eight (50.8%) patients were men and 1052 (49.2%) were women. The overall prevalence of PEX syndrome was found to be 27.9% and it was found to increase with progressing age. Bilateral PEX was more frequent than unilateral PEX, with the percentage of bilateral PEX raising with progressing age. A total of 132 patients (22.1%) in the PEX group exhibited glaucoma, while in the non-PEX group only 2.5% suffered glaucoma. PEX was also found to be positively associated with the risk for CAD among subjects 50 years or older. No association between CAD and glaucoma was found., Conclusions: PEX syndrome constitutes a major glaucoma risk factor and a CAD risk factor. Patients with PEX should be informed and examined frequently as the risk is present throughout.

Purpose: To investigate the oxidative status in lens epithelial cells of patients with pseudoexfoliation (PEX) syndrome., Methods: Lens capsule samples obtained during cataract surgery of patients with PEX syndrome and normal age-matched control subjects were examined for changes in the levels of glutathione (GSH), glutathione disulphide (GSSG), protein concentration, and lipid peroxidation. Concentrations of GSH, GSSG, lipid peroxidation, and protein concentration were determined by specific fluorescent assays., Results: This study shows a 2.2- and 2.0-fold decrease in GSH and GSSG levels, respectively, in PEX lens epithelial lens compared with non-PEX lens epithelial cells, as well as a 2.5-fold increase in lipid peroxidation product malondialdehyde (MDA) levels., Conclusion: The increased MDA and decreased GSH levels indicate high oxidative stress. On the other hand, GSSG usually increases in cases of high-oxidative stress, but this is not always the case, as it may not always accumulate in cells. Our findings suggest a role for oxidative stress in the pathogenesis and the progression of PEX syndrome.