If your vision was clear after cataract surgery but has gradually become cloudy or blurred again, you may wonder whether your cataract has come back.
No, it hasn't.
The most common cause is posterior capsule opacification (PCO) – clouding of the thin capsule behind your artificial lens implant. PCO can develop months or even years after cataract surgery and can cause blurred or misty vision, glare and reduced visual clarity. When PCO affects your vision, the good news is that it can easily be treated with a short laser procedure called YAG laser capsulotomy.
During cataract surgery, the cloudy natural lens is removed and replaced with an artificial lens implant. The natural capsule surrounding the lens is left in place to support the new lens.
Sometimes, cells remaining within this capsule cause it to become cloudy over time. This is called posterior capsule opacification, or PCO.
PCO is not the cataract growing back, and it does not mean that your artificial lens implant has become cloudy or developed a fault. Instead, the capsule behind the implant has become less clear, allowing less light to pass through the eye.
PCO can develop months or years after an otherwise successful cataract operation. Not everyone who develops PCO will need treatment; it is treated when the clouding is affecting vision or causing troublesome symptoms. However, we have a low threshold to treat PCO as the procedure is so quick, the risks are very low and even removing clearing mild clouding allows a big improvement to visual clarity.
PCO can cause symptoms including:
If your vision has deteriorated after initially improving following cataract surgery, PCO is one possible explanation. However, there are other reasons vision can change after cataract surgery, so an eye examination is important before deciding whether YAG treatment is appropriate. We must exclude problems with the retina, macula and cornea amongst others.
YAG laser capsulotomy is a laser treatment used to treat vision affected by PCO.
The laser creates a precise opening in the cloudy part of the capsule behind the artificial lens. This creates a clear pathway for light to reach the retina again.
It does not involve removing or replacing your artificial lens, and it is not another cataract operation. The procedure is performed in a seated position and does not require an operating theatre.
For nearly all patients, no.
Anaesthetic drops are used to numb the surface of the eye. During treatment, you may notice bright lights or clicking sounds, but the procedure itself should not be painful.
At Farnham Eye Care, YAG laser capsulotomy is described as a quick, painless outpatient procedure performed by Professor Dan Lindfield.
The laser treatment itself usually takes only a few minutes. You can go home straight away afterwards.
Before treatment, your eye and vision will be assessed and drops will normally be used to dilate the pupil.
You will sit at the laser machine with your head supported. Anaesthetic drops are used, and a special contact lens is usually placed gently on the eye to help focus the laser accurately.
The laser is then used to create an opening in the cloudy capsule. You may see bright lights and hear clicking sounds while the treatment is taking place.
Your vision may be blurred or dazzled temporarily after treatment because of the dilating drops and bright lights used during the procedure. You may also notice some floaters.
You should not drive until the effects of the dilating drops have completely worn off and your vision is clear enough to drive safely.
Post operative eye drops are not required (but if you already take regular eye medication then these must continue please)
Vision often becomes clearer in a few hours or days quickly, although the timing varies between patients.
YAG capsulotomy is generally considered a safe and relatively minor laser procedure, but no medical procedure is completely risk-free.
Possible complications include:
Your individual risks depend on your eyes and medical history, so these should be discussed with your ophthalmologist before treatment.
If you develop worsening pain, redness or loss of vision after YAG treatment, you should seek urgent advice from your eye clinic or appropriate emergency eye service.
Yes.
PCO can develop months or years after cataract surgery, so there is no single point at which someone will normally need YAG treatment. Some people may never develop PCO that requires treatment.
If your vision has gradually become cloudy or blurred after previously successful cataract surgery, an eye examination can determine whether PCO is responsible.
No.
YAG capsulotomy treats clouding of the capsule behind your existing artificial lens. The lens implant itself does not normally need to be removed or replaced.
This means that, where PCO is responsible for the change in vision, YAG can restore a clear optical pathway without another cataract operation.
If you have noticed a gradual return of cloudy, misty or blurred vision after cataract surgery, don't assume that your cataract has returned.
PCO is one possible cause and can often be treated with YAG laser capsulotomy. However, an eye examination is needed to establish the cause of your symptoms and whether YAG treatment is appropriate.
If you are still recovering from cataract surgery, you can also learn more about what to expect during cataract surgery recovery, including how your vision may change during the weeks following treatment.
At Farnham Eye Care, YAG laser capsulotomy is offered as a consultant-led treatment by Professor Dan Lindfield.
Learn more about YAG Laser Capsulotomy at Farnham Eye Care
No. Anaesthetic drops are used and most patients do not experience pain during the laser treatment.
If the cloudiness is caused by posterior capsule opacification, YAG capsulotomy can create an opening in the cloudy capsule and restore a clearer pathway for light.
The laser treatment itself usually takes only a few minutes, although you should allow additional time for assessment and dilating drops.
You should not drive until the effects of the dilating drops have completely worn off and your vision is clear enough to drive safely.
PCO / clouding can develop being your lens inplant months or years after cataract surgery. Nearly everyone will eventually develop it given enough time.
YAG capsulotomy is generally considered safe, but rarely complications can occur. Prof Lindfield will discuss the risks relevant to your individual circumstances before treatment so you can make an informed decision.
