Secondary cataract, or posterior capsule opacification or after-cataract, is one of the most common complications of cataract surgery.

Affecting nearly 20% of cataract surgery patients, it can occur within months or years after the person undergoes cataract surgery. Secondary cataracts do not allow light to pass through to the retina leading to loss of vision.

Often misunderstood, secondary cataract is not a recurrence of cataract that was operated upon previously. A cataract once operated will not return.

What Causes Secondary Cataract

During cataract operation, the surgeon carefully removes the clouded lens present in the eye from the lens capsule. The lens is then replaced with artificial Intraocular Lens (IOL). This lens is placed within a thin membranous bag called a capsule.

In secondary cataracts, the epithelial cells proliferate within the posterior capsule and also the new capsule that is supporting it.

One cannot determine with surety if and when a patient will develop secondary cataract after undergoing surgery. But, it typically happens in younger patients who underwent cataract surgery.

If you are encountering any vision problems after cataract surgery, then you should inform your doctor and get your eyes checked out.

Secondary Cataract Symptoms

Symptoms of secondary cataract is similar to that of a primary cataract. Some of the most common symptoms are:
  • Visual acuity problems which impact the near as well as far vision. It can occur in either single or both eyes
  • Blurry vision
  • Issues with frontal light during nighttime
  • Problems associated with the perception of colors
  • Sensitivity to sunlight

Tests to Confirm Secondary Cataracts

Your ophthalmologist will initiate a thorough medical examination of your eyes. The ophthalmologist may conduct the following tests to confirm the secondary cataract diagnosis:
  • Dilated eye examination
  • Slit-lamp
  • Visual acuity exam

Treatment For Secondary Cataracts

Once your ophthalmologist diagnosis you with secondary cataracts, he or she initiates appropriate treatment.

A capsulotomy is the treatment of choice for secondary cataracts. Capsulotomy involves the use of a laser to clear the opacification.

During capsulotomy, the ophthalmologist dilates your eyes with the help of anesthetic eye drops. Once the pupil is adequately dilated, you will proceed for laser surgery.

Under laser surgery, the ophthalmologist uses Nd: YAG laser to make a small incision in the clouded back lining of the capsule. A part of cells is removed which allows light to reach the retina through the membrane.

Your ophthalmologist will recommend laser surgery after proper assessment of the need for this intervention. The deciding factor is the visual deterioration and medical history.

Risks Associated With Nd: YAG

One of the most common complications of laser posterior capsulotomy is increased pressure (short-term) inside the eye. Your doctor might prescribe eye drops to help in lowering the ocular pressure.

Some other risks include:
  • Bleeding to the front of the eye.
  • Corneal edema
  • Displacement or damage to the intraocular lens
  • Macular edema
  • Retinal detachment

What Next After Nd: YAG Laser Treatment?

usually done on an outpatient basis, Nd: YAG laser capsulotomy is a quick and painless procedure.

After the completion of the surgery, you will be required to stay back for an hour or two to check for the ocular pressure. Once your ophthalmologist gives the all-clear sign, you can leave the hospital.

Regular follow-up is indicated, and should be done to ensure that everything is fine and there are no unwarranted complications. A regular check-up will help address any problem quickly.

In rare cases, in the days following the surgery, you might notice that vision is not yet back to normal, and the vision is still blurry.

If you are seeing any flashing lights, floaters, or a dark shade that is moving up and down or even sideways, then consult your ophthalmologist urgently to rule out any associated risks.