Purpose: To evaluate the tilt and decentration of crystalline lens of exfoliation syndrome using anterior segment optical coherence tomography (CASIA2, Tomey Corporation).
Methods: The study included 60 patients who were scheduled for lens reconstruction surgery at the same period at Hanamizuki Eye Clinic. The patients were distributed into two groups according to the presence or absence of exfoliation syndrome. The exfoliation syndrome group consisted of 30 eyes of 30 patients with exfoliation syndrome (78.3±4.2 years), and the control group consisted of 30 eyes of age- and gender-matched 30 patients without exfoliation syndrome (76.6±4.7 years). Before surgery, axial length was measured in all patients using the OA-2000 (Tomey Corporation), and the CASIA2 was used to measure the anterior chamber depth (ACD), anterior chamber width (ACW), crystalline lens diameter (LD), lens thickness (LT), and the tilt and decentration of lens. These measurements were compared between the two groups.
Results: No statistically significant differences were found between the exfoliation syndrome and control groups in AL, ACW, and LT (Student's t-test. p=0.511, p=0.133, and p=0.299, respectively). In the exfoliation syndrome group, lens decentration significantly increased (p=0.004) but ACD (p=0.036) and LD (p=0.041) significantly decreased compared with the control group. Lens tilt and decentration in the exfoliation syndrome group were significantly and positively correlated with age (Spearman's rank correlation coefficient. r=0.392, p=0.033; r=0.357, p=0.042, respectively) but significantly negatively correlated with ACD (r=-0.491, p=0.008; r=-0.502, p=0.006, respectively).
Conclusion: Increased decentration of crystalline lens in eyes with exfoliation syndrome may indicate the weakness of Zinn's zonule and can be preoperatively detected using the CASIA2.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 324-329, 2020.