26th Mar, 2019

What is a “secondary cataract”?

What is a “secondary cataract”?

San Diego cataract surgeon

Cataract is one of the most common causes of vision loss in the modern world. Fortunately, cataract surgery is able to restore vision for nearly all patients, by replacing the damaged natural lens of the eye with a clear artificial one. Nearly all patients experience an immediate restoration of vision. This procedure is the only way to restore vision in patients with cataract, and is successful in the vast majority of cases.

However, like all surgical procedures, there are certain risks with this surgery. One of them is the development of a so-called “secondary cataract.” What is this complication, and how do we help our patients who experience it?

Posterior capsular opacification (PCO)

The condition commonly referred to as a “secondary cataract” is not really a cataract at all. A cataract involves clouding of the lens of the eye. Once the damaged lens is replaced by an artificial lens, there is no further possibility of a cataract forming. Artificial lenses do not become cloudy and form cataracts in the way that a natural lens can. In this sense, the term “secondary cataract” is not quite accurate, because it doesn’t form in the lens itself.

What is commonly referred to as a “secondary cataract” is actually called posterior capsular opacification, and it’s caused by a thickening of the capsule around the lens. This natural membrane must be left in place during cataract surgery, in order to hold the new artificial lens in place. After surgery, scar tissue can form over the membrane, creating a cloudiness that can interfere with vision. Much like a cataract, this happens gradually (often over a period of years), causing a gradual reduction in vision. Patients may notice that their vision is hazy or blurry, or they may be bothered by glare.

How common is PCO?

Many factors influence the likelihood of developing PCO. These include the type of artificial lens implanted as well as the surgical technique. It’s estimated that approximately 10% of patients will develop PCO within three years of having their surgery, although this varies depending on the type of lens you choose. If PCO is a concern, make sure to mention this at your consultation appointment so we can explain which options are the least likely to lead to this complication.

What are the treatment options?

The visual changes caused by PCO, like those caused by a cataract, come on gradually. Early in the process, many patients are simply monitored, and may use glasses under certain conditions in order to manage their symptoms. At some point, you and your cataract surgeon may decide that your visual symptoms are bothersome enough to warrant having a procedure to correct the problem.

PCO is usually treated with a procedure known as a posterior laser capsulotomy. This procedure is a very simple and painless one, and can be done as an outpatient in about 15 minutes. The eye surgeon uses a laser to create a small hole in the capsule behind the lens. This creates a clear window through which light can pass, while still maintaining the rest of the lens capsule in order to hold the lens in place.

Laser capsulotomy restores clear vision in nearly all patients. Some patients experience “floaters” afterward, caused by the tiny pieces of scarred capsule that were removed. These usually only last for a few weeks after the procedure. There is also a very small increase in the risk of retinal detachment, a potentially serious condition. It’s important to carefully weigh the small risk of the procedure against your visual symptoms, and decide whether it’s worth having it.

Ask your San Diego cataract surgeon for more information

If you had cataract surgery, and you’re experiencing similar visual symptoms again, then you might have a secondary cataract (PCO). Please visit your San Diego cataract surgeon to discuss the possibility of having a laser capsulotomy to restore clear vision. To schedule your appointment, please contact our office.

Posted on March 26, 2019 By , in

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