Will My Cataracts Come Back?

   I am often asked if cataracts come back after cataract surgery.  The simple answer is no, but it’s not quite that simple.  Right behind your pupil sits the eye’s own natural lens.  This is what allows us to focus from distance to near.  As we get older, the lens starts to stiffen at first, requiring the need for reading glasses or bifocals.  This stiffening will continue and eventually cause the lens to become cloudy.  A cataract is simply the clouding of your eye’s own natural lens.  The cataract itself sits inside of a small bag called the capsule.  Small attachments known as zonules hold the capsule in place.  They are similar to the springs on a trampoline. 

   During cataract surgery, a hole is made in the front of the capsular bag (anterior capsule) and the cataract is removed.  Next, an intraocular lens implant is placed within the capsule.  Sometimes, after surgery, the capsular bag itself can become cloudy causing blurred vision or glare.  This is known as posterior capsular opacification, also called a “secondary cataract”.  This term is somewhat confusing since it is not actually the cataract that comes back, but rather a cloudiness of the bag that contained the cataract.  Posterior capsular opacification occurs in 25% to 50% of patients who have had cataract surgery and can occur months to years after cataract surgery.  

   The treatment is an in-office laser used to open a hole in the capsular bag to provide a clear window to see through.  This is called a YAG laser capsulotomy.  It only takes a few minutes and has minimal complications.  The main complication is a temporary increase in intraocular pressure that can be treated with eye drops in the office.  This occurs less than 1% of the time.  Occasionally, patients may develop floaters which are small remnants of the capsular bag.  These gradually fade with time.
If your vision is not quite as good as right after cataract surgery, it may be that the capsular bag has started to cloud.  If you have these symptoms, contact your eye care professional.  You might be a candidate for a YAG laser capsulotomy.

This newsletter does not constitute medical advice.  Make sure to contact your healthcare provider if you experience any of these conditions.  Do not make any changes to your medications before consulting your physician.