THE BLOOD-AQUEOUS BARRIER IN EYES WITH PSEUDOEXFOLIATION SYNDROME

Eyes with pseudoexfoliation syndrome (PEX) frequently show clinical si gns of impairment of the blood-aqueous barrier. Herein we give an over view of recent studies that analyzed the blood-aqueous barrier in eyes with PEX. Methods. The authors review and summarize recent studies in cluding quantification of aqueous flare in eyes with PEX using the las er flare cell meter (LFCM; Kowa FC-1000) in comparison with normal eye s and eyes with primary open-angle glaucoma (POAG), quantification of aqueous flare in eyes with PEX with and without secondary open-angle g laucoma (SOAG), and quantitative biochemical determination of total aq ueous protein concentration in PEX eyes. In addition, studies of nonin vasive quantification of the blood-aqueous barrier breakdown following trabeculectomy and following phacoemulsification with intraocular len s implantation in eyes with and without PEX are reviewed. Results: In eyes with manifest PEX, both aqueous flare and aqueous protein concent ration were significantly increased in comparison with normal control eyes and eyes with POAG. Flare values in PEX eyes with SOAG were not s ignificantly different from flare values in PEX eyes without SOAG. Fol lowing trabeculectomy as well as following cataract surgery, breakdown of the blood-aqueous barrier as determined by quantification of aqueo us flare was significantly higher in eyes with PEX than in eyes withou t PEX. Conclusions. Impairment of the blood-aqueous barrier with incre ase in aqueous protein concentration is a feature of PEX and may be qu antified both by flare measurement and by biochemical protein determin ation. The extensive blood-aqueous barrier breakdown in eyes with PEX following intraocular surgery is an important risk factor for early or late postoperative complications. The alterations of the blood-aqueou s barrier should be considered in the medical and surgical treatment o f eyes with PEX.