Posterior Capsule Opacification (Secondary Cataract)

Posterior capsule opacification (PCO), also known as “secondary cataract”, refers to the clouding of the posterior lens capsule of the eye that can occur after cataract surgery.

This clouding leads to decreased visual performance as the incoming light is scattered. Fortunately, this condition can be corrected through a simple and painless laser treatment to restore clear vision.

Read on to discover answers to what is posterior capsule opacification and more.

What is Secondary Cataract?

A cataract, medically referred to as a cataract, is an eye condition in which the natural lens of the eye becomes cloudy. A secondary cataract, medically known as posterior capsule opacification, is a common complication that can occur after a successful cataract surgery or a refractive lens exchange.

This leads to blurred vision, glare, and reduced visual acuity. A cataract typically develops over time due to aging or factors such as diabetes, injuries, or genetic predisposition. The treatment usually involves surgery.

In cataract surgery, the cloudy natural lens of the eye is removed and replaced with a clear artificial lens, also known as an intraocular lens (IOL). During the procedure, the lens capsule is left intact to position the IOL. The lens capsule is a thin, transparent membrane that surrounds the lens in the eye. It consists of an anterior and a posterior layer. The posterior lens capsule can become cloudy weeks, months, or even years after such a treatment. This is the most common cause of secondary cataract.

What Causes a Secondary Cataract?

There are a few secondary cataract causes. They may occur due to cell proliferation in the posterior lens capsule of the eye. Some cells of the posterior lens capsule may remain on the capsule surface after the surgery. These remaining cells can become active and proliferate over time, leading to clouding of the capsule.

This clouding scatters the incoming light and impairs vision. Not everyone who undergoes cataract surgery necessarily develops a secondary cataract. However, the possibility exists due to natural cell processes in the eye.

What are the symptoms of a secondary cataract

After cataract surgery, a secondary cataract can cause various symptoms that impair visual performance. It is important to note that these symptoms do not always appear immediately after cataract surgery. A secondary cataract can develop over weeks or months, with symptoms gradually emerging and worsening.

The most common symptoms include:

Blurred Vision

The clouding of the posterior lens capsule leads to blurred vision or a slight haze over the visual field. Fine details can be difficult to see, and seeing clear outlines may be impaired.

Cloudy Vision

Affected individuals often report a cloudy, milky, or foggy appearance of their surroundings. This effect can cause the environment to appear less clear and vibrant.

Increased Glare Sensitivity

A secondary cataract can increase sensitivity to bright light. Affected individuals often find themselves more strongly dazzled in bright light conditions or near light sources like the sun or lamps.

Altered Colour Perception

Some people notice a change in their perception of colors. Colors may appear muted or less intense, leading to a general impairment of visual experiences.

Difficulty with Night Vision

People with a secondary cataract may have difficulty seeing in low light conditions or in darkness. This can make driving at night or recognizing objects in poorly lit environments more challenging.

Secondary Cataract Treatment - How Can Secondary Cataract Be Treated?

The treatment of a secondary cataract usually involves a minimally invasive eye laser treatment known as YAG capsulotomy. Laser treatment for posterior capsule opacification is extremely effective and does not require hospitalisation.

A YAG capsulotomy is an outpatient procedure typically performed in an eye clinic or by an ophthalmologist. The procedure begins with the administration of eye drops to dilate the pupil and numb the eye, ensuring a painless treatment.

The ophthalmologist uses a powerful YAG laser to direct a tiny, precise laser beam through the anterior chamber of the eye. This laser beam strikes the cloudy posterior lens capsule, creating a tiny opening. Through this opening, the incoming light can again pass unimpeded to the retina, resulting in a sharp and clear image in the brain.

The YAG capsulotomy is painless and usually takes only a few minutes. The treatment requires no stitches, as the opening is self-healing. Patients can notice an immediate improvement in visual performance right after the YAG capsulotomy.

In most cases, the YAG capsulotomy requires no special follow-up care. Normal activities can typically be resumed immediately. However, regular check-ups are recommended to ensure stable vision and no complications.

Overall, the YAG capsulotomy is a proven and safe treatment for secondary cataract to effectively restore visual performance.