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New research · Ophthalmology
Cureus · 23h
Cohort studyCureus · 2026

Surgical Outcomes and Complication Profile of Cataract Surgery in Eyes With Pseudoexfoliation Syndrome: A Prospective Observational Study.

Kapil Shahare, Hari Kumar S, Ankur Upadhyay, Komala S B
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OphthalmologyCohort study

Most patients with pseudoexfoliation syndrome achieve good vision after cataract surgery.

Surgical Outcomes and Complication Profile of Cataract Surgery in Eyes With Pseudoexfoliation Syndrome: A Prospective Observational Study.

Kapil Shahare et al. · Cureus · 2026
Background

And aim Pseudoexfoliation syndrome (PXS) substantially elevates the technical complexity of cataract surgery through its twin mechanisms of restricted pupillary dilation and progressive zonular weakness.

Purpose

This study aimed to document the intraoperative complication spectrum and postoperative visual rehabilitation following small incision cataract surgery (SICS) with intraocular lens (IOL) implantation in eyes with concurrent PXS and to identify preoperative predictors of adverse surgical outcomes.

Methods

This prospective observational study enrolled 50 consecutive eyes of 50 patients with coexisting visually significant cataract and PXS at a tertiary ophthalmology center in Bihar, India.

72%
Results
patients with this eye condition achieved good vision after cataract surgery
More results

The cohort was predominantly male (31 (62%)) and elderly (29 (58%) aged above 70 years; mean age, 70.4 ± 8.6 years).

Intraoperative complications included difficulty with anterior capsulotomy in nine (18%) eyes, posterior capsular rent in five (10%), zonular dehiscence in four (8%), and vitreous loss in four (8%).

More results

All complication rates correlated significantly with inadequate pupillary dilation (p < 0.05).

Posterior capsular opacification in nine (18%) and cystoid macular edema in four (8%) were the leading causes of suboptimal visual rehabilitation.

“
Conclusion · 1 of 2

Although PXS significantly amplifies surgical risk relative to routine cataract cases, structured preoperative planning, maximal pupillary dilation, and appropriate intraoperative adjuncts consistently yield visual outcomes comparable with published benchmarks.

Conclusion · 2 of 2

Preoperative pupillary dilation status is a robust, statistically significant predictor of intraoperative morbidity and should guide surgical strategy.

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