Can Cataracts Come Back After Surgery?

Here at Optegra, we’ve spoken to thousands of people weighing up the pros and cons of cataract surgery. Two of the most common patient questions we hear are: Is cataract surgery painful, and can cataracts come back after surgery?

These are valid concerns. Thankfully, cataract surgery is usually straightforward and painless. And as for whether cataracts come back after surgery, we’ll explain everything you need to know below.

Can Cataracts Come Back?

In short, no. Once a cataract has been removed, it cannot grow back.

Cataracts develop when the natural lens of the eye becomes cloudy, leading to blurred or misty vision. Cataract surgery removes the cloudy lens and replaces it with a clear, artificial lens known as an intraocular lens (IOL). Once this lens is in place, it cannot develop a cataract.

What About Cataracts Coming Back a Second Time?

Patients sometimes report a gradual blurring of vision months or even years after surgery and worry their cataract has returned. But in reality, cataracts cannot come back a second time. Usually, what they’re experiencing is something called Posterior Capsule Opacification (PCO), which is sometimes referred to as a secondary cataract.

Why Cataracts Don’t Come Back

“It’s a great question, and it’s something we hear often. Let’s be clear: the cataract is gone for good. The original cloudy lens is replaced with an artificial intraocular lens (IOL), made of a material that cannot develop a cataract. The blurring that sometimes occurs later is not the cataract returning; it’s merely a clouding of the natural membrane that holds the new lens in place. This condition, Posterior Capsular Opacification (PCO), is very common, completely separate from the original cataract, and requires only a quick, painless laser treatment to fix.” 

– Alastair Stuart, Medical Director and Consultant Ophthalmic Surgeon, Optegra Eye Health Care

What is Posterior Capsule Opacification (PCO)?

PCO is a common and treatable side effect of cataract surgery. It happens when the clear membrane that holds the intraocular lens (known as the posterior capsule) becomes cloudy over time. This cloudiness can affect your vision in a similar way to the original cataract symptoms, which is why many people believe their cataract has come back.

Symptoms of PCO include:

• Blurry or misty vision.
• Increased glare or halos, especially at night.
• Reduced contrast or visual sharpness.

PCO can occur months to years after surgery. Whilst it’s not harmful, it can be frustrating. The good news is that it’s easily treated with a quick laser procedure.

How is PCO Treated?

If your optometrist or ophthalmologist diagnoses PCO, the standard treatment is a YAG laser capsulotomy – a simple, painless outpatient procedure that takes only a few minutes.

During this treatment, a special laser creates a tiny opening in the cloudy capsule, allowing light to pass through again. Vision typically improves immediately, and the results are long-lasting.

Can Cataracts Come Back After YAG Laser Treatment?

Once treated with a YAG laser, the chances of PCO returning are low, but it’s not impossible. Less than 1% of patients may experience a recurrence within 12 months*. If needed, the procedure can be repeated safely.

So, while a cataract cannot return, PCO is a known possibility after surgery, but one that can be quickly resolved.

What If My Vision Feels Cloudy After Cataract Surgery?

If your vision becomes gradually blurry or cloudy weeks, months or even years after your operation, don’t panic. This doesn’t mean your cataract has returned, but you should book an eye exam to rule out any other conditions and check for PCO. 

When to Seek Advice After Cataract Surgery

“After cataract surgery, it’s essential that patients never worry in silence. If you notice any significant vision changes, such as gradual  blurriness or increased glare, that persistent cloudiness is most likely the easily fixable PCO. However, any new symptom needs professional assessment. In particular if you experience a sudden drop in vision, pain or redness in the eye please contact us immediately rather than waiting for your next appointment. Please reach out to ensure we can identify and quickly resolve the issue.”

– Alex Shortt, Consultant Ophthalmic Surgeon, Optegra Eye Health Care

Book Your Free Consultation

Thinking about cataract surgery? At Optegra, we offer free, no obligation virtual consultations so you can ask a professional all of your questions, from whether cataract surgery is painful to what happens if cataracts come back. Book online today or call us on 0800 086 1064.

Download a free information pack to learn about the surgery, recovery, and long-term results.

*Source: McPherson RJ, Govan JA. Posterior capsule reopacification after neodymium:YAG laser capsulotomy. J Cataract Refract Surg. 1995 May;21(3):351-2. doi: 10.1016/s0886-3350(13)80146-0. PMID: 7674176.