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Call 704.365.0555By: Pujan Dave, MD | June 13, 2023 | Blog, Cataracts, Pujan Dave, MD
Cataract removal remains the most common surgery in the United States every year. Most patients who have cataract surgery with intraocular lenses (IOLs) implanted do very well. They see more clearly and need glasses only to read, only for long distances, or perhaps not at all. Some, though, encounter a condition called posterior capsular opacification (PCO), which can occur anytime from months to years after the surgery.
Luckily, an ophthalmologist can fix this issue in just a few minutes at the office, rather than through surgery. The process is painless, simple, covered by insurance, and the problem rarely (or most would say never) comes back.
What Is PCO?
You may hear this condition referred to as “secondary cataract” or “after-cataract.” That’s a misnomer. Unlike your natural lens, the implanted IOL itself will never thicken or cloud over. The problem in this case is the lens capsule, the thin membrane that surrounded your natural lens and now surrounds the implant.
Normally, epithelial cells do beneficial work for the body, on the surface of your skin acting as a safety shield and serve lots of important functions inside the body. In the eye after cataract surgery, however, epithelial cells within the lens capsule may start to migrate behind the IOL that was implanted. Soon, this may cloud your vision again.
Diagnosing and Fixing PCO
If you have this condition, you’re likely to get symptoms similar to the ones that made you seek cataract surgery in the first place. For instance, you may experience cloudy, blurred or fuzzy sight, glare or halos around lights, light sensitivity, or trouble reading.
A doctor will dilate the affected eye(s) and examine them through a slit-lamp machine, as in your annual eye exam. The ophthalmologist can then use a YAG laser in the office to break up that opacification (“scar tissue”) that has formed to create a clear field of vision. Once you have this procedure, you’re not likely to need it again.
Certain lens designs may be slightly more likely to provoke PCO than others. However, ophthalmologists don’t typically consider this significantly when discussing lens options with patients because PCO can easily be fixed.
Dislocation of the IOL
On rare occasions, the implanted lens can shift out of place, which can sometimes cause distortion or blurry vision. Trauma to the head or eye can cause that displacement. The lens capsule is held together by little fibers called zonules. If the zonules weaken, the IOL can move. There are a variety of conditions that can cause weak zonules, including a certain type of glaucoma named pseudoexfoliation. If the lens does dislocate, an ophthalmologist can perform surgery to “fix” the lens in place.
Conditions to Consider Before Treatment
Certain factors increase the risk of PCO. Someone with uveitis or other intraocular inflammation could be more likely to develop it. Younger patients in general, who have stronger immune responses, may be more likely to develop PCO.
Other vision-related problems, including diabetic retinopathy, glaucoma, and retinitis pigmentosa, have been associated with an increased risk of a “secondary cataract.” However, as noted above, the solution for PCO remains a simple one that can be performed at any time.
To schedule a consultation with a cataract specialist at Horizon Eye Care, call 704-365-0555 Monday-Thursday, 8 a.m. to 5 p.m., or Friday, 8 a.m. to 3 p.m. The optical department closes on Fridays at 2:30 p.m.