To compare the refractive outcomes after cataract surgery between patients with and without pseudoexfoliation, and to evaluate the risk factors of refractive error. Methods:Retrospective review of 210 eyes with pseudoexfoliation (study group) and 510 normal eyes (control) that underwent uneventful phacoemulsification with intraocular lens implantation. The study group included pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) subgroups. The main outcome measure was refractive error, defined as the difference between the target refraction and postoperative refraction in diopter (D). A refractive error >± 1.0 D was identified as a large-magnitude refractive error. The frequency of the large-magnitude refractive error was compared between study and control groups, and also between each subgroups and normal eyes. The factors influencing refractive error were analyzed by logistic regression.Results: There was a significantly higher frequency of a refractive error >± 1.0D and hyperopic error >1.0 D in the study group than in the control group (p=0.001, p=0.003; respectively). In the multivariate logistic regression analysis, PXG and poor preoperative visual acuity were related with a large-magnitude refractive error (p=0.001 and p=0.02, respectively) Refractive error >± 1.0 D and hyperopic error >1.0 D were noted more often in PXG eyes that had an intraocular pressure (IOP) spike >25 mmHg at postoperative first 24 hours (p=0.01, p=0.03; respectively). Conclusions:The eyes with pseudoexfoliation were at high risk for refractive error, especially in the presence of glaucoma. In PXG, the only significant risk factor for refractive error was observed to be the presence of an IOP spike.

Background: It has been reported that some patients with lacunar infarction have transient ischemic attacks (TIAs) before stroke. This study was aimed at evaluating the factors and prognostic value related to TIAs preceding acute lacunar stroke. Methods: A total of 1,424 patients were admitted to the hospital for first-ever ischemic stroke. Of which 314 patients with acute lacunar infarction were enrolled for this study. The patients were divided into 2 groups based on the occurrence of TIAs before stroke. Results: Fifty-eight patients (18.5%) had a history of preceding TIAs. The interval between TIA and stroke was less than 24 h in most patients (87.9%). Diabetes mellitus was more often found in patients with TIAs than in those without TIAs (48.3 vs. 28.9%, p = 0.004). Initial National Institute of Health Stroke Scale scores showed no significant difference between the 2 groups (median 2 vs. 3, p = 0.067). However, patients with preceding TIAs had a more favorable outcome (modified Rankin scale 0-1) than those without TIA at 3 months after stroke (79.6 vs. 63.2%, p = 0.021). Conclusion: Lacunar TIA may occur due to small perforating microatheromatous arteries caused by diabetes. This study suggests that ischemic tolerance may play a role in patients with preceding TIAs before lacunar infarct, allowing better recovery from a subsequent ischemic stroke.

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