AIM: To evaluate the influence of pseudoexfoliation syndrome(PEX)on conjunctival cells and tear functions.

METHODS: This study included 86 eyes of 60 patients with PEX and 89 eyes from 55 normal age-matched individuals. Tear film break-up time(TBUT), Schirmer's tests were performed and impression cytology(IC)specimens were obtained from upper and interpalpebral inferonasal bulbar conjunctiva for all 175 eyes of 115 cases. IC specimens were graded according to Nelson's method. The correlations between results of TBUT, Schirmer's test and the findings of impression cytology specimens were evaluated.

RESULTS: Patients with PEX had lower Schirmer's tests and TBUT and also revealed significant conjunctival cell alterations when compared with normal subjects. The median cytology scores were Grade 3 and Grade 0 in PEX patients and normal subject, respectively. Mixed involvement with more than one grade type change was observed in 45 specimens in cases with PEX and only in 3 specimens in the control cases. Besides, epithelial and goblet cell discordance was found in 45 specimens in the group with PEX which was not observed in the control group.

CONCLUSION: Destruction of conjunctival cytology combined with decreasing in tear tests demonstrates the presence of ocular surface disease in PEX.