This condition is typically but not exclusively associated with people of Northern European background. It is most common in people from Scandinavian countries.
Most patients with PXF proceed through cataract surgery with an uneventful course. The zonules, which suspend the lens capsule in the eye, have an inherent weakness in PXF. In those uncommon circumstances where the capsular bag is excessively unstable, the intraocular lens (IOL) may need to be positioned in an alternative position, either in the sulcus or anterior chamber. Even more rarely, where the zonules are particularly weak and the cataract falls to the back of the eye, a second operation is required.
There are advantages in patients with PXF having surgery earlier. When there is a cataract that is allowed to mature and become larger, the potential for trauma to the zonules is increased, as is the risk of the need for alternative positioning of the IOL.
In some patients with PXF, eye pressure becomes elevated after cataract surgery. Typically, such pressure rises are controlled with drops. In rare circumstances where the pressure is unable to be controlled in this way, glaucoma surgery is required.
The likelihood of zonular instability and high pressures after cataract surgery is higher if the procedure is performed when the cataract is in a more advanced state.