Is there such a thing as a second cataract?
I remember my grandmother going through cataract surgery about 30 years ago whilst I was still a junior college student. She was anxious and I remember her having a bruise around her eye because she put on her protective shield so tightly for many days after the cataract surgery. Understandably when her vision became blurred again years later, she refused to have her eyes checked for fear she would have to go through cataract surgery again. This memory of my Grandma has had a large impact on my care for all my patients undergoing cataract surgery. I realise how important it is to tell patients what to expect in the short and long term because it would allay their fears as they know how to react when it occurs.
Cataracts once properly removed surgically will never grow back again. The surgery is once in a lifetime. However, over time, there is some haziness of the vision due to the growth of epithelial lens cells. which causes the lens capsule to thicken and become slightly opaque. This is called a posterior capsular opacification (PCO). PCO is NOT a result of a complication during or from your cataract surgery. It is however an unavoidable after effect of cataract surgery. It is easily treated, and the vision is restored very quickly; as long as there is no other associated ophthalmic pathology.
Why does this happen?
The natural lens in the eye is surrounded by a capsule rather like the chocolate of an M n M surrounded by say a green coating. During cataract surgery the lens (chocolate) is removed through a small incision in the front of the lens capsule and the new intraocular lens is put in its place. Inside the original lens are epithelial cells, during cataract surgery these cells are removed with the cloudy lens, however it is unavoidable that some of the microscopic cells may remain. These epithelial cells grow along the lining of the capsule that is behind the intraocular lens. This is the Posterior Capsule Opacity (PCO).
What should be done?
The treatment is easy, very safe, takes a few minutes, is painless and the vision is restored the minute the dilating drops wear off. I have yet to see any complications of the treatment. At The Eyeclinic by Dr Cheryl Lee, it is even more convenient as the Yag Laser machine is in the clinic.
Dilating eye drops, a painless laser whilst you are sitting up and it’s done, and you can do everything as per normal.
It is also done just once ever, and it doesn’t grow back again. Why? Because there is no scaffold for the epithelial cells to grow on anymore. That’s why one shouldn’t delay treating a PCO when it forms.