After cataract surgery, the artificial lens that is implanted is completely clear and should provide excellent vision. In the weeks and months after the surgery, it is possible for a type of scar tissue or fibrotic tissue to grow and cloud the new artificial lens. This can lead to a posterior capsular opacification or secondary cataracts.
While a secondary cataract may exhibit many of the same symptoms as a cataract, the two are actually quite different. A secondary cataract is much less cumbersome to treat and is usually treated with an in-office laser procedure. Following the laser procedure, there is no recurrence or regrowth of the posterior capsular opacification.
What is Posterior Capsular Opacification?
The capsule of the lens is a connective tissue bag or sack that helps hold the crystalline lens in place.
The back of the lens capsule is where a secondary cataract or posterior capsular opacification can form.
The tissue that makes up the lens capsule can have cells that migrate onto the surface and develop a type of scar tissue or film.
Why the Lens Capsule is Left In Cataract Surgery
When a cataract is removed, the crystalline lens is extracted from the eye, but the capsule which it sits inside is left in place.
This capsule is needed to help hold the new artificial lens that is implanted during the surgery.
However, once the lens is implanted and the eye has healed around it, it no longer requires the support of the lens capsule.
Symptoms of a Secondary Cataract
The most common complaints associated with posterior capsular opacification are new blurry vision, haziness, glare associated with night vision and halos around lights.
Like a true cataract, a secondary cataract blocks some light from passing through the eye into the back of the eye or retina.
When the amount of light is limited, it can cause difficulty with distinguishing details or impede contrast sensitivity.
Since there is a film of scar tissue on the back of the artificial lens implant, it can cause light to scatter and result in glare and halos.
Treatment for Secondary Cataracts
The treatment for a secondary cataract is to use a laser procedure to remove the scar tissue from the capsule and leave it open and clear.
The laser used for this procedure is called a YAG laser and the procedure can be performed in a clinic or office and does not require an operating room.
The YAG laser procedure usually takes only minutes to actually perform but the entire visit may last up to an hour due to the need to dilate the eyes and then instill eye drops after the procedure.
Following a YAG laser procedure, there are very few restrictions or considerations. There are no restrictions on driving, sleeping, washing the face, or lifting as there are with traditional cataract surgery.
After the YAG laser procedure, there are usually one to two follow-up visits to ensure that the posterior capsular opacification is completely cleared and the eye is healing properly.