n association between pseudoexfoliation (PEX) and cataracts has been shown in many previous studies. Recently, the Australian Blue Mountains Eye Study, using the Wisconsin Cataract Typing and Grading System, observed an increased prevalence of nuclear cataract in eyes with PEX. The purpose of this study was to study the relationship between PEX and cataract surgery in a cohort comprising a substantial number of exposed individuals. Survival analyses were performed in a cohort of 760 residents 65-74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984-1986. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978–2007. In total, the cohort comprised 1471 individuals, representing more than 15,900 person-years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records. By the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38-fold (95% confidence interval 2.01–2.84) increased risk.