Posterior Capsule Opacity

Cataract surgery complications are few, and cataract surgery is among the most common and most successful surgical procedures performed today.

According to the American Society of Cataract and Refractive Surgery (ASCRS), 3 million Americans undergo cataract surgery each year, with an overall success rate of 98 percent or higher.

Also, a recent study of more than 200,000 Medicare beneficiaries who underwent cataract surgery between 1994 and 2006 found that 99.5 percent of patients had no severe postoperative complications and the risk of severe complications has decreased with advances in surgical tools and techniques.

When cataract surgery complications do occur, most are minor and can be successfully treated medically or with additional surgery.

Posterior Capsule Opacity – A Common Cataract Surgery Complication

One of the most common cataract surgery complications is a posterior capsule opacity (also called posterior capsule opacification or PCO).  Although some people call PCO a “secondary cataract,” it really is not a cataract.  Once a cataract is removed, it does not come back.

During cataract surgery, your surgeon will remove the cloudy natural lens of your eye (cataract) and replace it with an intraocular lens (IOL).  Much of the thin clear membrane that surrounds the natural lens (called the lens capsule) is left intact during surgery and the IOL  is implanted within it.

When the cataract is removed, your surgeon makes every attempt to maintain the integrity of the lens capsule, and normally your vision after cataract surgery should be very clear.

However for many patients, the posterior portion of the capsule becomes hazy some time during cataract surgery recovery or even months later, causing PCO.  Posterior capsule opacification occurs because lens epithelial cells remaining after cataract surgery have grown on the capsule. In some cases, if the condition progresses significantly, your vision may be worse than it was before cataract surgery.

Treating Posterior Capsule Opacity

Fortunately, a YAG laser can treat posterior capsule opacity safely, effectively and painlessly.  This procedure, known as YAG laser capsulotomy, often can be performed in your doctor’s office.

YAG laser capsulotomy involves just a few simple steps:

  • Usually the eye is dilated before the procedure, with dilating eye drops.
  • A laser removes the hazy posterior capsule from your line of sight without making an incision or “touching” the eye.
  • Many ophthalmologists recommend anti-inflammatory eye drops following the procedure.

The procedure takes only a few minutes and is entirely painless; nor does discomfort occur post-operatively.

Following a YAG laser capsulotomy, you may resume normal activities immediately.  You may experience some floaters afterward.  These will likely resolve within a few weeks.

Most people can expect their vision to improve within a day.  As with any eye procedure, however, call us or the surgeon  immediately if vision worsens or fails to improve.

YAG Laser Capsulotomy Risks

Although a YAG laser capsulotomy poses slight additional risk, overall the procedure is extremely safe.  The most important risk is that the retina can become detached from the inner back of the eye.

Statistics suggest that the lifetime risk of a detached retina as a cataract surgery complication in the United States is about 1 percent. That number rises to about 2 percent after YAG laser capsulotomy.  It is important to be aware of this cataract surgery risk.

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