Can cataracts come back after surgery?

No, it is not possible for cataracts to reoccur in the operated eye after surgery. Namely, during cataract surgery, the naturally cloudy lens that is in it is removed from the capsular bag using an ultrasound machine and an artificial intraocular lens is placed in its place. This lens, which remains permanently in the eye, becoming its integral part and taking over the function of the natural lens, cannot be blurred.

However, in a smaller number of patients, over time, the so-called secondary cataracts or, more correctly, opacification (clouding) of the capsular bag. It is a case of thickening and clouding of the capsule, where the clouding of its rear part hinders the passage of light rays. In this way, the gradual reduction of the transparency of the capsule leads to a gradual weakening of vision.

Secondary cataract most often occurs a year or two after surgery, although it can also occur in the later postoperative period. Research has shown that secondary cataract occurs more often in:

• younger people because the epithelial cells on the equator (the side of the capsule) are more potent, reproduce faster and migrate through the capsule towards its center;
• in patients who have some other diseases of the inner part of the eye (most often inflammation)
• in patients who have undergone some other intraocular operations, e.g. vitrectomy with silicone oil, as well as during the installation of some types of intraocular lenses (most often silicone) during cataract surgery.

Previously, secondary cataracts were removed using a knife – cystotome (needle) to make an opening in the central part of the clouded capsule, which was risky due to the possibility of numerous complications. Thanks to technological progress, today the treatment of secondary cataract is a quick, painless and reliable intervention that is carried out by the so-called Nd YAG laser . This non-contact procedure is called a posterior capsulotomy and is performed on an outpatient basis under local drip anesthesia. It only takes 2-3 minutes and is completely painless. The effect is visible immediately after the treatment and what is even more important, it is permanent (after capsulotomy it is not possible to re-fog the lens capsule).

Before the intervention, it is necessary to dilate the pupils with short-acting drops. During the treatment, the patient hears soft sounds and sees a red light. Laser beams are directed towards the cloudy part of the capsule, opening its central part. With each pulse, the opening expands to the required width. After the treatment, the patient goes home, following the doctor’s instructions. During the day, temporary blurring of vision is possible until the pupil contracts, as well as a temporary jump in eye pressure and mild eye irritation. These symptoms are short-lived and the patient usually feels comfortable during the day, and the vision improves to the level it was at before the secondary cataract appeared.