Abstract
PURPOSE: This study aimed to compare serum iron (Fe), zinc (Zn), and magnesium (Mg) levels between cataract patients with and without pseudoexfoliation (PEX) syndrome and to investigate their potential role as biomarkers in PEX and pseudoexfoliation glaucoma (PEXG). METHODS: In this case-control study, 41 eyes of 41 patients with visually significant senile cataract and PEX formed the study group. The control group comprised 39 eyes of 39 age- and gender-matched cataract patients without PEX. Serum Fe, Zn, and Mg levels were compared. The primary analysis employed a Generalized Linear Model (GLM) to evaluate adjusted mean differences, controlling for age and sex. RESULTS: GLM analysis revealed that serum Fe levels were significantly higher only in the PEX-only group compared to controls (β = 14.057, p = 0.023). Serum Zn levels were significantly lower in both the PEX (β = -72.010, p = 0.031) and PEXG groups (β = -192.957, p < 0.001) versus controls, with the deficit being markedly more pronounced in PEXG. No significant differences were found in serum Mg levels between groups (all p > 0.05). Visual field mean deviation was not significantly associated with any serum element level. CONCLUSION: Patients with PEX exhibited altered serum trace element homeostasis, characterized by elevated Fe and reduced Zn levels. The finding of a more profound Zn deficiency in PEXG suggests a biological gradient linked to disease severity. These results indirectly support the involvement of oxidative stress in PEX and PEXG pathogenesis. Further multi-center studies are warranted to validate these findings and explore their clinical relevance.