Does exfoliation mean I need cataract surgery?

Exfoliation of the lens capsule means the surface fibers on the outer membrane (capsule) of the lens are peeling or flaking off. The correct term is usually called "pseudo-exfoliation." This finding is fairly common and by itself doesn't mean you need cataract surgery. You do need to be examined and followed regularly by an ophthalmologist, as this flaking is often associated with glaucoma, which can be treated with eyedrops. Cataract surgery with this condition is slightly more complicated and associated with potentially more early and late complications. The indication for surgery is still based on the visual needs of each patient and how satisfied he is with his current vision, so exfoliation by itself is not a reason to remove the cataract.