Refractive Outcomes After Uneventful Phacoemulsification in Eyes With Pseudoexfoliation Syndrome, Pseudoexfoliative Glaucoma, and Primary Open-Angle Glaucoma

Objective: To compare biometric parameters and refractive outcomes after uneventful phacoemulsification cataract surgery among patients with pseudoexfoliation syndrome (PXS), pseudoexfoliative glaucoma (PXG), primary open-angle glaucoma (POAG), and a control group.Methods: This retrospective study included 174 eyes divided into four groups: PXS, PXG, POAG, and controls. Demographic characteristics, including age and sex, were recorded. Preoperative biometric parameters such as anterior chamber depth (ACD) and axial length were measured. Refractive outcomes were assessed using target spherical equivalent (SE), postoperative SE, mean refractive error (MRE), and mean absolute error (MAE). Refractive error magnitude and direction were also analyzed.Results: The mean age of the study population was 71.04 ± 7.43 years, and there were no statistically significant differences among the groups in terms of age or sex distribution (p > 0.05). There were no statistically significant differences among the groups in terms of preoperative ACD, axial length, target SE, postoperative SE, MRE, or MAE (p > 0.05 for all).The MAE values were 0.57 ± 0.67 D in the PXS group, 0.56 ± 0.53 D in the PXG group, 0.57 ± 0.42 D in the POAG group, and 0.49 ± 0.45 D in the control group. The distribution of refractive error magnitude (≤0.50 D, 0.50–1.00 D, and >1.00 D) and direction (myopic or hyperopic) were similar among the groups (p > 0.05).Conclusions: Biometric parameters and refractive outcomes were similar among PXS, PXG, POAG, and control eyes. Despite the potential zonular instability and postoperative IOP fluctuations associated with pseudoexfoliation and glaucoma, refractive predictability remained comparable across all groups after uncomplicated phacoemulsification.