To the Editor.
—I read with interest the article by Skuta and colleagues.1 Being from Minnesota, which has a large population of Scandinavians, we see a great deal of pseudoexfoliation in our practice. Skuta and associates noted a particular risk for large zonular dialysis during extracapsular surgery. They believe that this risk could be attributed to weakness of the lens zonules or their attachments to the ciliary processes. I believe that such may be the case, but I would like to offer a second reason why zonular dialysis may be occurring with cataract surgery. It is my impression, as well as that of others in my seven-member group, that the cortex in persons with pseudoexfoliation syndrome is "sticky." That is, it is much more difficult during the aspiration phase of the cataract extraction to pull cortex out of the fornices of the capsular bag. It is as though
Allen JS. Zonular Dialysis in Pseudoexfoliation Syndrome. Arch Ophthalmol. 1987;105(10):1318–1319. doi:https://doi.org/10.1001/archopht.1987.01060100020005
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