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A case-control study of exfoliation risk factors and literature review

Poster Details

First Author: H. Mansour LEBANON

Co Author(s):    A. Konstas   A. Mansour   A. Charbaji   K. El Jawhari           

Abstract Details


To evaluate risk factors associated with exfoliation in a case-control setting.


This single center, prospective, case-control study was carried out from January 2010 to April 2020 on patients operated for cataract surgery by a single surgeon in Lebanon.


Forty-nine consecutive patients with exfoliation syndrome (XFS) and 62 control patients were identified and further investigated for selected systemic (diabetes mellitus, systemic hypertension, asthma or atopy) and l ocular variables (baseline vision, severity of nuclear sclerosis, glaucoma, eye rubbing, history of dry eye or allergic eye disease).


XFS demonstrated significantly denser nuclear sclerosis than controls (p=0.00958). By univariate analysis, allergic conjunctivitis (15 (30.6%) vs. 2 (3.2%); p=0.001), dry eye (20 (40.8%) vs. 13 (21.0%); p=0.0133) and habitual rubbing of the eyes (33 (67.3%) vs. 19 (30.6%); p=0.001) were associated with the presence of XFS. Habitual ocular rubbing was closely associated with allergic conjunctivitis (odds ratio OR= 13.0 95% CI: 2.8-58.8; p=0.032). After multivariable analysis, the following variables showed significant results: glaucoma (OR= 34.5 95% CI: 4.4-250; p=0.010), duration of surgery (OR= 5.6 95% CI 2.43-12.9; p=0.001) and habitual ocular rubbing (OR= 4.42 95% CI:1.97-9.90; p=0.029).


This study shows a novel potential correlation between eye rubbing and XFS in a Lebanese cohort. Chronic eye rubbing induces or may exacerbate pre-existent zonular damage in subjects with XFS hence the need to better manage concurrent ocular surface disorder in these patients.

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