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Doc: Cataract surgery complicated by rare syndrome

Keith Roach
To Your Health

Dear Dr. Roach: I went to the ophthalmologist to have my eyes evaluated. After a series of tests, he told me that I have a cataract and normal eye pressure, but I also have a rare inherited disease called pseudoexfoliation. He said it will cause many complications if I have cataract surgery, and then he walked out before I could ask him what the disease involves.

I went home and looked it up on the web.

I totally frightened myself with what I read.

I know sometimes the web isn’t the best source for medical advice, but since he left me with no knowledge of the situation, I wish you could explain what it is and what the implications are.

E.H.

Dear E.H.: Pseudoexfoliation syndrome causes the deposition of white, fluffy protein material in the front part of the eye. It is rare in young people, but is present in about 5 percent of people between 75 and 85. There is indeed a strong familial component to the condition, and a gene has been identified.

It increases the risk of cataract, but especially increases the risk of glaucoma, with excess pressure in the eye. Both cataract and glaucoma treatment are more challenging in the case of pseudoexfoliation syndrome, but cataract surgery still can be done, with low risk, by an experienced surgeon.

It may be that your cataract is not yet bad enough to merit surgery; however, if you are having significant vision problems because of the cataract, it might be worthwhile to find an expert in cataract surgery with pseudoexfoliation syndrome.

About 15 to 30 percent of people with the syndrome will develop glaucoma, so you will need to see an eye specialist frequently to keep a careful eye on your pressure, and possible treatment (usually eyedrops) to prevent glaucoma.

Email questions to ToYourGoodHealth@med.cornell.edu.