Intraocular pressure following phacoemulsification in patients with and without exfoliation syndrome: a 2 year prospective study.

AIM: To determine the long term intraocular pressure (IOP) response to phacoemulsification in patients with and without exfoliation syndrome (XFS). METHODS: Prospective, multicentre, cohort study with the following inclusion criteria: age over 50 years, open iridocorneal angle, and cataract. Two groups were enrolled: those with XFS and those without. The main outcome was mean IOP reduction 2 years after phacoemulsification cataract extraction (PCE). Univariate and multivariate analyses were performed. RESULTS: 183 patients were enrolled, 71 with and 112 without XFS. There were 29 patients with glaucoma in both groups. Mean baseline IOP was higher in XFS compared to control eyes (17.60 (SD 3.23) mm Hg v 16.08 (3.18) mm Hg, p = 0.002). Overall IOP reduction was significantly greater in the XFS group at the 2 year time point (-1.85 mm Hg v -0.62 mm Hg in the controls (p = 0.0037)). Multivariate analysis demonstrated that the IOP lowering effect in the XFS group may be related to irrigation volume at the time of surgery. In the subgroup analyses IOP lowering was significantly greater in the XFS and XFG patients than in controls without glaucoma, and POAG controls, respectively. The percentage of patients with a postoperative IOP spike was similar and relatively high in both XFS and control groups (34% v 25%; p = 0.54). CONCLUSION: IOP decreases more in patients with XFS following PCE compared to control eyes without XFS. This effect is more pronounced in glaucoma patients and persists for at least 2 years.

Intraocular pressure decrease after phacoemulsification in patients with pseudoexfoliation syndrome.

PURPOSE: To determine the intraocular pressure (IOP) response to phacoemulsification cataract extraction with posterior chamber intraocular lens (PC IOL) implantation in patients with pseudoexfoliation syndrome. SETTING: Eye clinics at the University of Ottawa Eye Institute, Ottawa, Ontario, Canada. METHODS: A retrospective cohort study design assigned patients to 1 of 3 subgroups: pseudoexfoliation syndrome (PEX) (n = 21), primary open-angle glaucoma (POAG) control (n = 23), and cataract control (n = 23). Inclusion criteria consisted of age older than 50 years, open angle by gonioscopy, and a cataract requiring phacoemulsification. The IOP response was determined at intervals up to 18 months. RESULTS: Postoperative IOP changes from baseline in the PEX group were -1.81, -4.52, and -2.31 mm Hg at 3, 6, and 12 months, respectively. The changes in the POAG control group were -2.22, -2.32, and -1.88 mm Hg, respectively, and in the cataract control group, -2.49, +0.45, and +0.28 mm Hg. Patients in the PEX group had a reduction in IOP from baseline at all postoperative measurements. That reduction was significantly greater than in the POAG and cataract control groups at 6 months (P =.012 and P =.002, respectively) and 12 months (P =.001 and P =.050, respectively). CONCLUSIONS: Patients with pseudoexfoliation syndrome had a postoperative IOP reduction from baseline at all measurements and a significantly greater reduction than patients in the POAG and cataract control groups at 6 and 12 months. Phacoemulsification cataract surgery with PC IOL implantation may be effective in managing patients with pseudoexfoliation syndrome who have elevated IOP and visually significant cataract but no advanced optic nerve damage.

Prevalence of eating disordered behavior in collegiate lightweight women rowers and distance runners.

OBJECTIVE: This study examined eating behavior in collegiate women lightweight rowers, runners, and controls. It was hypothesized that rowers would show an increased prevalence of restraint in their eating behaviors, but not probable eating disorder cases as compared with runners or controls, because they are required to make their target weight but are discouraged from further weight loss. DESIGN: Retrospective survey. SETTING/PARTICIPANTS: Lightweight women rowers (n = 122) at eastern collegiate championship regattas, collegiate distance runners (n = 79) at a regional track meet, and a convenience sample of collegiate controls (n = 95) were surveyed. MAIN OUTCOME MEASURE: The Eating Disorders Examination-Questionnaire, a validated questionnaire evaluating eating attitudes and behaviors, and additional questions regarding weight and menstrual history were used to assess probable eating disorder cases and disordered eating tendencies. RESULTS: Rowers showed significantly more restraint in eating patterns during the previous month and less shape concern than either runners or controls. Rowers also reported increased use of diuretics. There were no significant differences between groups in terms of probable cases of eating disorders or disordered eating behavior. CONCLUSIONS: Lightweight rowing and distance running were not associated with increased prevalence of eating disorders in this sample, although rowing was associated with increased restraint and diuretic misuse. This use of pathologic weight-making behaviors is of significant clinical concern. These results support ongoing monitoring of disturbed eating and weight-making practices in weight-dependent sports, but do not support discouraging the growth of lightweight women's rowing at the collegiate level.