Corneal Biomechanics and Surgically Induced Astigmatism in Pseudoexfoliation Syndrome

Pseudoexfoliation syndrome is associated with structural alterations of the anterior segment and may affect the biomechanical behavior of the cornea. Corneal hysteresis (CH) and corneal resistance factor (CRF), measured using the Ocular Response Analyzer, are indicators of corneal biomechanical properties and may influence the corneal response to cataract surgery and magnitude of surgically induced astigmatism.

This prospective, single-center observational study will include approximately 70 patients undergoing routine phacoemulsification cataract surgery. Participants will be allocated into two groups according to the presence or absence of pseudoexfoliation syndrome.

CH, CRF and corneal astigmatism will be measured preoperatively and postoperatively at scheduled follow-up visits at postoperative day 1, 7 and 30. Surgically induced astigmatism will be calculated from keratometric measurements.

The primary objective of the study is to determine whether correlations exist between corneal biomechanical properties (CH and CRF) and surgically induced astigmatism in patients with pseudoexfoliation syndrome and to compare these correlations with those observed in patients without pseudoexfoliation syndrome.

Inclusion criteria

• Adults aged 50-85 years
• Age-related cataract scheduled for standard phacoemulsification cataract surgery with intraocular lens implantation
• Presence of pseudoexfoliation syndrome (PEX group) or absence of pseudoexfoliation syndrome (control group)
• Ability to provide written informed consent
• Willingness to attend all scheduled postoperative follow-up visits

Exclusion criteria

• Previous ocular surgery in the study eye
• Corneal diseases or abnormalities that may affect corneal biomechanical measurements or keratometry
• Glaucoma and ocular hypertension
• Ocular trauma or active ocular inflammation