1- Increase in intraocular pressure which with time can lead to secondary open angle glaucoma. Sometimes and because weakness of the zonules, the natural lens will subluxated and move forward to block the pupil. This will cause acute closure angle glaucoma can also occur.
2- Poor iris dilation which is due to iris ischemia. This can be a problem in case of cataract surgery because the iris should be fully dilated to enable the surgeon to remove the cataract without complications. With poor dilated pupil, there will be a high risk of intra-operation complications such as rupture of the posterior capsule and drop of the cataract or part of it to the back of the eye.
3- Weakness of the Zonules. Zonules are special thin fibers that held the natural intraocular lens in place.Due to zonules weakness, there will be phacodonesis which can cause a high incidence of subluxation of lens or even drop of the lens into the posterior part of the eye either during intraocular surgery or after trauma.
Subluxated lens (cataract) into the back of the eye is one of the complications that can occur during cataract surgery for patients with pseudoexfoliation glaucoma.
4- Post intraocular surgery inflammation is higher in patient with Pseudoexfoliation than in other groups. This inflammation can increase the risk of synechia or adhesions between the iris and the lens or between the iris and intraocular lens.