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Can Cataracts Come Back?

30 March 2022

Here at Optegra, we’ve spoken to thousands of potential patients weighing up the pros and cons of cataract surgery. Generally, we’ve found our clients are mostly concerned about the degree of pain they might experience after surgery, and whether there’s any possibility of cataracts returning after surgery

These are valid concerns. It’s natural for us to associate surgery with pain – and to shy away from the discomfort of the treatment table, even when our bodies clearly require medical attention. Thankfully, cataract surgery is usually straightforward and painless.

So, what about the issue of cataracts coming back? We totally understand the worry – what’s the point of committing to a procedure, if the problem’s just going to rear its head further down the line? Let’s dig a little deeper.

Can cataracts come back after surgery? 

In short, no. Once a cataract removal procedure has been performed, it is impossible for a cataract to “grow back”.

A cataract is a cloudy patch that develops on the eye’s lens, causing blurry or misty vision. Cataract surgery involves removing the cloudy lens and replacing it with a clear, artificial intraocular lens.

Since the intraocular lenses used in cataract removal procedures cannot develop cloudy areas in the same way as our eyes’ lenses do, cataracts will never return after surgery. So, you can rest easy: once you’ve had your cataracts removed, you won’t need to go through the procedure again.

What’s more, many of our clients praise cataract surgery for giving them a new lease of life. Several have told us they didn’t realise how much their eyesight had deteriorated – a 2013 study, from the U.S. Library of Medicine, claimed quality of life increases 36 percent after cataract surgery.

That said, in some cases, patients report their vision reclouding after cataract surgery. Of course, many wrongly assume this is caused by their cataract returning. In fact, this is actually caused by a side effect of cataract surgery called posterior cataract opacification.

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    So, what causes posterior capsule opacification?

    When cataract surgery is performed, the cloudy lens is removed, but the lens capsule – the membrane which surrounds the ocular lens – remains in place.

    In fact, as Ocular Surgeon Uday Devgan explains, the lens capsule plays a ‘pivotal role’ in any cataract removal procedure, since it ‘acts as a barrier to separate the anterior segment from the vitreous cavity, it supports the cataract nucleus during phacoeemulsification, and it holds the IOL securely at the end of the case.’ Simply put, the lens capsule is vital because it holds the intraocular lens in place.

    However, in some cases scar tissue will form on the capsule, causing it to cloud over. This is what we call posterior capsule opacification – also occasionally known as ‘secondary cataracts’. Aside from cloudy vision, symptoms include bright glares, seeing double and reduced focus.

    The University of Michigan’s Kellogg Eye Center claims one in five cataract surgery patients will suffer from posterior capsule opacification. A 2019 Harvard study claimed that patients with a history of glaucoma, uveitis or retina surgery are likely to be at greater risk of suffering from posterior capsule opacification, as are those who have cataract surgery before turning 60. The choice between LASIK or LASEK therapies has no impact on the likelihood of posterior capsule opacification occurring.

    Can you prevent posterior capsule opacification?

    Unfortunately, even if you’re aware that you may be predisposed to developing posterior capsule opacification, there’s no way of preventing the condition from occurring.

    Thankfully, posterior capsule opacification can be easily fixed – by a simple, painless, outpatient procedure called YAG laser capsulotomy.

    The procedure makes use of a laser to forge a hole in the lens capsule, allowing light to travel to the back of the eye – and in turn, improving vision.

    While the surgery itself often takes just minutes to perform, the NHS recommends allowing two hours for a YAG laser capsulotomy appointment – and warns that patients should not drive home after surgery, as vision can remain blurry in the minutes and hours following the procedure.

    YAG laser capsulotomy is totally painless, but the bright light from the laser will cause temporary ‘dazzling’. Vision should return within five to ten minutes, with full clarity usually restored in the six hours after surgery.

    Can posterior capsule opacification return after YAG laser capsulotomy?

    The Royal National Institute for Blind People reports that it is extremely rare for posterior capsule opacification to come back after a YAG laser capsulotomy. Very occasionally, certain cells may form around the capsule leading to a recurrence of posterior capsule opacification, but this can usually be easily fixed with further simple laser treatment.

    If you’re thinking about cataract surgery, why not get in touch today? Book a free virtual consultation online or by phone at 08082567434. Or order a free, detailed infopack; We’ll be more than happy to answer any questions you may have about the procedure, and to assist in any way possible.

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