Combined true exfoliation and pseudoexfoliation of the lens capsule

Background True exfoliation of the lens capsule is rare, and its occurrence with pseudoexfoliation in the same eye is very unusual. Case Report An 81-year-old female presented with bilateral cataracts and a history of working with ceramics in her home kiln. Slit-lamp examination revealed pseudoexfoliation. She underwent intracapsular cataract extraction and sector iridectomy in both eyes. Light and electron microscopy of the lenses revealed a central area of splitting of the anterior lens capsule into a thin anterior and a thicker posterior layer, and deposits pseudoexfoliation material on the anterior lens capsule, on the iris pigment epithelium, and in the iris stroma. Conclusions We interpret our findings as representing a combination of true exfoliation and pseudoexfoliation, but we did not observe any signs that might indicate a correlation or a common pathogenesis of the two conditions. Although they may occur in one eye, true exfoliation of the lens capsule and pseudoexfoliation are two unrelated distinct entities.