What Are Secondary Cataracts?

What You Need to Know About Secondary Cataracts

“Cataract” is an eye disease that signifies a clouded natural eye lens. A clouded lens causes poor vision, and sometimes complete vision loss if left untreated. 

Cataract development is generally associated with natural aging, but this eye disease can be caused by a number of factors, including hypertension, diabetes, previous eye injuries, family history, and exposure to UV radiation.

As we age, our chances of developing cataracts increase drastically. By age 80, more than half of all Americans have cataract disease. The prevalence of cataract disease has given rise to numerous types of cataract surgeries—from standard cataract surgery, to advanced laser-assisted cataract surgery and refractive cataract surgery. 

One of the risks associated with cataract surgery is the potential development of secondary cataracts post-surgery. ‘Secondary cataracts,’ sometimes referred to as ‘after-cataracts,’ is an eye condition that occurs after cataract surgery. 

The medical term for secondary cataract disease is posterior capsular opacification (PCO). PCO is actually one of the most common complications after cataract surgery. It’s determined that about 20% of patients who have undergone cataract surgery will develop secondary cataracts. 

What are the signs and symptoms of secondary cataracts (PCO)?

Secondary cataracts can develop within months or years after cataract surgery is completed. Because secondary cataract is still a cataract, the signs and symptoms of PCO are similar to the signs and symptoms of primary cataract (the cataract that was initially present).

A person with secondary cataracts may experience:

• Blurry or hazy vision
• Difficulty perceiving nearby objects
• Difficulty perceiving far-away objects
• Difficulty perceiving colors and contrasts
• Light glares
• Halos around lights

After primary cataract surgery, your eye doctor will schedule follow-up appointments in increments up to six months after surgery to monitor the potential development of secondary cataracts. If you have undergone cataract surgery, and you begin to experience any of the common symptoms or signs of PCO, it’s important that you notify your eye doctor.

What Causes Secondary Cataracts?

Secondary cataracts occur when protein starts to accumulate on the posterior lens capsule of the eye. The posterior lens capsule is a capsule in the back of the eye that contains the artificial IOL (intraocular lens) implanted during cataract surgery. 

To implant an intraocular lens and remove the natural cloudy lens, the eye surgeon will make an incision in the front of the capsule. The posterior capsule, or back of the capsule, will stay in place to hold the new lens.

In some patients, the epithelial cells of the previous natural lens still remain in the posterior capsule. Over time, these cells will proliferate and cluster together, which clouds the capsule and inhibits light from reaching the retina. Thus, the clump of epithelial cells will obstruct sight, leading to an opaque lens capsule and clouded, hazy vision. 

Who is at Risk of Developing Secondary Cataracts?

It’s nearly impossible to anticipate who will develop secondary cataracts, but one risk factor is certain—for a person to develop a secondary cataract, they must’ve had a primary cataract.

People who are under the age of 60 and have previously undergone cataract surgery, glaucoma surgery, or retina surgery are at a higher risk of developing secondary cataracts. Ironically, primary cataracts are more common in people over the age of 60, but secondary cataracts occur more often in patients under the age of 60. 

How are secondary cataracts treated?

The only treatment to eradicate secondary cataracts is a YAG laser capsulotomy. The YAG laser capsulotomy is a simple outpatient procedure and is completed in a clinic in as little as a few minutes. 

When a lens capsule becomes opaque with clumps of epithelial cells blocking light from passing through to the retina, vision becomes blurry and misty. The purpose of a laser capsulotomy is to create an opening in the murky lens capsule for light to pass through the posterior capsule. 

During a laser capsulotomy, the eye doctor will make an incision in the posterior capsule using an advanced YAG laser. The advanced YAG laser penetrates a small hole in the center of the posterior capsule, which allows light to pass through to the retina.

Prior to the capsulotomy, the eye doctor will administer medical eye drops that cause the pupil to dilate. An anesthetic eye drop will also be administered to numb the surface of the eye. 

The eye doctor will place a special lens on the eye to enable a clear close-up of the eye membrane before initiating the YAG laser. The laser is then applied to the eye with accuracy and precision to create a hole in the posterior capsule—and voila! The capsulotomy is complete; the secondary cataract is broken up; vision is restored. 

What to Expect After Secondary Cataract Treatment

About an hour after the quick and painless YAG laser capsulotomy, your eye doctor will assess your eye pressure to ensure that there is no infection or risky inflammation. 

The eye doctor will then examine the posterior capsule to verify that the procedure was successful and did not cause any adverse effects. For a few hours after the procedure, you may experience some minorly blurred vision. This is a normal effect of the eye drops administered.  

If you notice any “eye floaters,” or small pieces of debris that drift through your vision, it’s important to visit your ophthalmologist immediately to mitigate potential complications.

Following YAG laser capsulotomy, a secondary cataract is not likely to return. 

Choosing an Ophthalmologist for Secondary Cataract Treatment

When choosing an ophthalmologist to complete a laser capsulotomy, it’s important to find one who understands the delicacy and complexity of the eye. Dr. Mehul Patel is one of the top-rated medical specialists who performs cataract surgery in Orlando.

Dr. Patel is thorough and focused in his work, and he strives to ensure that each of his patients is highly informed about their diagnoses and available treatment options in surgery. 

With a passion for ophthalmology and restoring patients’ vision, Dr. Mehul Patel aims to enable optimal refractive outcomes for patients who require cataract surgery. He is known for prioritizing patient education and patient comfort to provide a superior treatment experience.

Sources:

Prevent Blindness America: http://www.visionproblemsus.org/cataract/cataract-definition.html

All About Vision: https://www.allaboutvision.com/conditions/cataract-complications.htm

Ophthalmology Center Barcelona: https://icrcat.com/en/eye-conditions/secondary-cataract/

NVISION EYE CENTERS: https://www.nvisioncenters.com/cataracts/secondary/

Harvard Medical School: https://www.health.harvard.edu/diseases-and-conditions/are-you-at-risk-for-a-secondary-cataract