Exfoliation syndrome (XFS) is an age-related, generalized disorder of the extracellular matrix characterized by production and progressive accumulation of a fibrillar material in tissues throughout the anterior segment and also in connective tissue portions of various visceral organs. Mature exfoliation fibrils are composed of 8-10 nm microfibrils resembling elastic microfibrils. The exact chemical composition of exfoliation material (XFM) remains unknown. It appears to consist of a complex glycoprotein/ proteoglycan structure composed of a protein core surrounded by abundant glycoconjugates. The protein components include both non-collagenous basement membrane components and epitopes of the elastic fiber system, particularly components of elastic microfibrils. Overall, XFS is the most common identifiable cause of glaucoma, accounting for the majority of cases in some countries, and causing both open-angle glaucoma and angle-closure glaucoma. Iridolenticular friction leads to loss of XFM from the anterior lens surface and disruption of the iris pigment epithelium, resulting in pigment deposition in the trabecular meshwork, which also produces XFM locally. The primary cause of chronic pressure elevation appears to be the active involvement of trabecular cells and Schlemm's canal cells in particular, in the generalized pathologic matrix process with subsequent degenerative changes of Schlemm's canal and adjacent tissues. Narrow angles and angle-closure are common in XFS. Pupillary block may be caused by a combination of posterior synechiae, increased iris thickness or rigidity, or anterior lens movement secondary to zonular weakness or dialysis. Enlargement of the lens due to cataract formation and relative pupillary constriction are additional factors.

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青光眼为什么与剥脱综合征有关？

剥脱综合征（XFS）是一种与年龄相关的，普遍存在的细胞外基质疾病，其特征是在整个前节的组织以及各种内脏器官的结缔组织部分中，纤维状物质的产生和逐步积累。成熟的脱落原纤维由类似于弹性微纤维的8-10 nm的微纤维组成。剥离材料（XFM）的确切化学成分仍然未知。它似乎由复杂的糖蛋白/蛋白聚糖结构组成，该结构由被丰富的糖缀合物包围的蛋白质核心组成。蛋白质成分包括非胶原基膜成分和弹性纤维系统的表位，特别是弹性微纤维的成分。总体而言，XFS是可识别的青光眼的最常见原因，在某些国家占大多数病例，并导致开角型青光眼和闭角型青光眼。虹膜突状摩擦导致晶状体前表面XFM的损失和虹膜色素上皮的破坏，导致小梁网中的色素沉积，这也局部产生XFM。慢性压力升高的主要原因似乎是小梁细胞特别是Schlemm的管细胞的积极参与，特别是在广义病理学基质过程中，Schlemm的管和邻近组织随后发生退行性变。窄角和闭角在XFS中很常见。瞳孔阻滞可能是由于后粘连，虹膜厚度或硬度增加，或因小带无力或透析引起的晶状体前移所致。