Objective: To evaluate the prevalence of pseudoexfoliation syndrome (PEX) among Ethiopian patients with age-related cataract scheduled for surgery.

Methods: In a prospective study, 229 consecutive eyes with age-related cataract scheduled for surgery were evaluated for the prevalence of PEX, type of cataract, intraocular pressure (IOP) and glaucoma.

Results: The mean age of the 229 patients was 62.1 +/- 10.5 years (range 47-91 years). The prevalence of PEX was 39.3% (90 of 229 eyes). Pseudoexfoliation syndrome was bilateral in 62.2% (56/90) of cases. The mean age of those with PEX (63.7 +/- 10.7 years) was significantly more than that of those without PEX (60.3 +/- 9.2 years) (p = 0.01). The prevalence of PEX significantly increased with age (p = 0.02). Patients with hypermature cataract had significantly more PEX (p < 0.001). Mean IOP was significantly higher in eyes with PEX (18.4 +/- 3.2 mmHg) than in those without PEX (15.8 +/- 3.6 mmHg) (p < 0.001). Significantly more eyes in the PEX group had IOP > 21 mmHg (p < 0.01) and established glaucoma (p < 0.05). An incidence of PEX was found in all major ethnic groups in Ethiopia. There was no significant difference in the prevalence of PEX between the different ethnic groups (p > 0.5).

Conclusions: The prevalence of PEX among Ethiopian patients with cataract is high and occurs at a relatively younger age when compared to previous reports from Europe. Pseudoexfoliation syndrome has been found to be significantly associated with hypermature cataract, higher mean IOP, IOP > 21 mmHg and glaucoma. Population-based studies are recommended to evaluate the prevalence of PEX in the general population and its association with cataract and glaucoma.