Sometimes called a ‘secondary cataract’, a posterior capsule opacity can occasionally occur after a cataract operation.
In a cataract operation, we replace the cloudy lens with a clear, artificial lens. However, in some cases, a hazy membrane can form just behind the intraocular lens implant. This is known as posterior capsule opacity, and we can treat it easily.
Although the condition is sometimes referred to as a ‘secondary cataract’, it’s important to note that a genuine cataract cannot reoccur after cataract surgery.
A posterior capsule opacity will only occur after cataract surgery. If you have recently had a cataract operation, and have blurred, hazy vision or see a lot of glare from lights, it may be because of a posterior capsule opacity.
Blurring and loss of vision from posterior capsule opacity are usually gradual, just as with real cataracts. While the symptoms are very similar to cataracts, there is no chance of an actual cataract re-forming after cataract surgery.
During a cataract operation, the surgeon will carefully remove the cataract from the affected eye and replace it with an artificial intraocular lens (IOL).
The lens is located within a very thin membrane ‘bag’ called the capsule. To remove the lens and replace it, the surgeon must open the front of the capsule. The back or ‘posterior’ of the capsule remains intact to support the new lens.
In a small proportion of patients – around 10% – the old lens’s outer cells remain and grow on the capsule. This causes the capsule to become hazy or clouded, which results in blurred vision.
The treatment for posterior capsule opacity is very simple. We use a procedure called a YAG laser capsulotomy to remove the haziness and restore normal vision. It is a fast, painless and very effective treatment.
YAG laser capsulotomy involves a special laser that makes a small hole to break off the opacity in the capsule bag after your cataract surgery to restore normal vision.
Is it common?
It is relatively common and can occur in 10-20% of cataract surgery patients.
How long does it take to recover from Yag laser capsulotomy?
The Yag procedure is quick and pain-free and, therefore, does not require any recovery time. Some patients do, however, notice some floaters for a few weeks after the procedure.
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Posterior capsule opacification (PCO) is the most common complication of cataract surgery. PCO can cause significant visual symptoms and is effectively treated with laser capsulotomy. Evolving understanding of the underlying pathophysiology has led to modifications in surgical techniques and intraocular lens designs with the potential to decrease the incidence of PCO. Click here to read more.
Posterior capsule opacification (PCO) occurs as a result of natural post-surgical wound healing in the eye, and can lead to patients losing some of their vision months or years after undergoing cataract surgery.
The new in vitro capsular bag model, developed by University of East Anglia scientists and West Norwich Hospital ophthalmologists, benefits from spatial organization and cell types found in real-life patients.
Researchers are working on improving the human model, replicating regenerative features of PCO and examining a range of IOLs to determine the best outcomes for patients. Click here to read more.
In their influential 2001 study, “Eradication of Posterior Capsule Opacification: Documentation of a Marked Decrease in Nd:YAG Laser Posterior Capsulotomy Rates Noted in an Analysis of 5416 Pseudophakic Human Eyes Obtained Postmortem,” Apple et al provided valuable insight into factors with bearing on the development of posterior capsule opacification (PCO) occurring after cataract surgery in a comparative autopsy tissue analysis of 5416 pseudophakic postmortem eyes collected between January 1988 and January 2000.
Eyes studied had received 8 different intraocular lenses (IOLs) that were available in the United States, including rigid and foldable IOLs. The authors developed a computerized model that allowed them to predict trends or timelines of neodymium:yttrium–aluminum–garnet (Nd:YAG) laser rates for each IOL design, and they identified 6 factors related to surgical technique and IOL choice that seemed to influence PCO. Addressing these factors ultimately may well eradicate PCO, the second most common cause of reversible visual loss worldwide after cataract. Click here to read more.