The retrospective study included 193 cataract patients who underwent phacoemulsification combined with intraocular lens (IOL) implantation between December 2023 and January 24. Patients were divided into good outcome (n=138) and poor outcome (n=55) groups based on best-corrected visual acuity (BCVA) and complications 3 months after surgery. The poor outcome group had significantly higher levels of IL-20 and lower levels of Apelin-13 in both preoperative serum and intraoperative ventricular fluid (p<0.05), along with higher history of diabetes, CRP, and IL-6 (p<0.05). Multivariate logistic regression analysis confirmed that higher levels of IL-20 and lower levels of Apelin-13 in aqueous humor and serum are independent predictors of poor postoperative outcomes. ROC curve analysis showed that levels of IL-20, Apelin-13 and their ratio in ventricular fluid effectively predict postoperative outcomes. Apelin-13 acts as a protective factor for favorable outcomes, while IL-20 is a risk factor. These biomarkers have potential for preoperative risk assessment and personalized treatment strategies.