Tissue involvement Clinical signs Clinical complications Surgical complications
Cornea - atypical cornea guttata - endothelial decompensation - endothelial proliferation - endothelial decompensation
Trabecular meshwork - pigment deposition - marked asymmetry of IOP - marked IOP rise after pupillary dilation - intraocular hypertension - open- angle glaucoma - postoperative IOP rise
Iris - peripupillary atrophy and iris sphincter region transillumination - melanin dispersion associated with pupillary dilation - poor mydriasis, asymmetric pupil sizes - melanin dispersion - poor mydriasis - iris rigidity - blood- aqueous barrier impairment - pseudouveitis - anterior chamber hypoxia - posterior synechiae - miosis/poor surgical access - intra- and postoperative hyphema - postoperative inflammation - prolonged blood- aqueous barrier breakdown - posterior synechiae and pupillary block
Lens, ciliary body, and zonules - diffuse precapsular layer - phacodonesis - PEX deposits on zonules - cataract - phacodonesis - lens subluxation - angle- closure glaucoma due to pupillary and ciliary block - zonular rupture/dialysis - vitreous loss - posterior capsule rupture - decentration of the lens implant - anterior capsule fibrosis - secondary cataract
Table 1: Clinical signs and complications of pseudoexfoliation (PEX) syndrome.