Here at Optegra, we’ve spoken to thousands of potential patients weighing up the pros and cons of cataract surgery. Generally, two of the most frequently asked patient questions are: is cataract surgery painful, and can cataracts come back?
These are valid concerns. 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.
Do Cataracts Come Back?
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.
This synthetic lens serves to permanently correct the vision and, indeed, prevent the cataract from growing back. The process can be explained in the following way:
Cataract Removal: During cataract surgery, the surgeon carefully removes the clouded, natural lens of the eye, which is the cataract itself. This lens has become opaque and is causing vision problems. Once removed, the cataract cannot regrow because the entire lens is taken out.
Replacement with IOL: In place of the cataract-affected natural lens, a synthetic intraocular lens (IOL) is implanted. The IOL is a clear and durable artificial lens that remains inside the eye permanently. It serves to focus light onto the retina, allowing for clear vision.
Cataract Prevention: Since the natural lens responsible for the cataract has been completely removed and replaced with an IOL, there is no remaining tissue that could develop a new cataract. Therefore, the cataract does not grow after the surgery.
That said, in some cases, patients report their vision reclouding after cataract surgery. Of course, many wrongly assume this is caused by their cataracts returning. In fact, this is caused by a side effect of cataract surgery called posterior cataract opacification.
What is Posterior Capsule Opacification and What Causes it?
Posterior Capsule Opacification (PCO), also known as “after-cataract” or “secondary cataract,” is a condition that can occur after cataract surgery. It often leads to symptoms of blurred or clouded vision, which can be confusing and may make patients think that their cataracts have returned. Here’s an explanation of PCO and how it can be mistaken for cataract recurrence:
What is PCO? PCO occurs when the clear, posterior capsule of the eye, which supports the intraocular lens (IOL) implanted during cataract surgery, becomes thickened or cloudy over time. This cloudiness can result from the residual lens epithelial cells, which were not removed during the initial surgery, growing and multiplying on the capsule.
Symptoms: PCO can cause visual disturbances, such as blurred or hazy vision, glare, difficulty with night vision, and decreased contrast sensitivity. These are similar to those experienced with cataract symptoms, leading some individuals to believe that their cataracts have returned.
Confusion with Cataract Recurrence: The blurriness and clouded vision experienced with PCO can be easily confused with cataract recurrence. Patients may worry that their cataracts are coming back, especially if they are not aware of the possibility of PCO.
Distinguishing PCO from Cataracts: Eye care professionals can differentiate PCO from cataracts through a comprehensive eye examination. During this examination, they will examine the posterior capsule to assess its condition. If PCO is the cause of the symptoms, it can be treated effectively.
Treatment for PCO: PCO is treatable with a simple and painless procedure known as YAG laser capsulotomy. In this procedure, a laser is used to create an opening in the cloudy posterior capsule, allowing light to pass through clearly. The vision usually improves immediately after the treatment, and no incisions or sutures are involved.
PCO can be treated by a painless procedure known as YAG laser capsulotomy.
Can Posterior Capsule Opacification Return After YAG Laser Capsulotomy?
Posterior capsular rates can vary, with an estimate of 4% within 12 months. 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.
By Author: Alex J Shortt
Mr Shortt is a leading ophthalmic surgeon and an expert in the fields of cornea, cataract and refractive surgery.
Medically Reviewed Date: 2nd November 2023