- A secondary cataract (posterior capsular opacification) is a clouding of the lens capsule, not a regrowth of the cataract.
- It can develop weeks, months, or even years after cataract surgery.
- Symptoms are nearly identical to original cataracts: blurred vision, glare, halos, faded colors.
- Treatment is a YAG capsulotomy – a 5‑minute, in‑office laser procedure that restores clear vision.
- You do not need another cataract surgery; the YAG laser creates a small opening in the cloudy capsule.
Have you noticed your vision is steadily declining and worsening? If you’ve undergone cataract surgery and are experiencing cloudy vision, you may have a secondary cataract.
Also called an after-cataract or posterior capsular opacity (PCO), a secondary cataract can develop weeks, months, or years after removing your original cataracts. Keep reading to learn more about secondary cataracts, how to correct them, and why a second opinion may be necessary.
What is a Secondary Cataract?
Understanding posterior capsular opacification (secondary cataract).
To better understand what a secondary cataract is, it’s essential to know what a cataract is and what happens during cataract surgery. A cataract occurs when proteins in your eyes break down and clump together on the eye’s natural lens.
As cataracts develop, you may experience blurred or cloudy vision, halos and glare, poor night vision, sensitivity to light, double vision, and faded colors. Cataract surgery is the only effective way to treat cataracts and restore your ability to see clearly.
During cataract surgery, your cataract surgeon creates a small incision in the cornea and front part of the lens capsule. However, the back portion of your capsule is left intact to support the new intraocular lens implant.
The capsule is a thin, bag-like membrane that holds your lens in the proper position. Your surgeon can access your lens through the incisions made.
They may use a laser to break the cataract into tiny pieces before removing those fragments using gentle suction. Finally, a new intraocular lens (IOL) is implanted to replace the lens.
How the lens capsule is preserved during cataract surgery.
The incisions made are usually left to close by themselves. Therefore, no stitches are needed. A cataract can’t develop on the intraocular lens, meaning it’s also impossible to have another cataract.
You won’t need to have cataract surgery twice. Even though cataracts can’t return once removed, you may develop posterior capsular opacification.
Why the capsule becomes cloudy and how YAG laser fixes it.
Your lens capsule can become cloudy when epithelial cells move to the rear portion of the capsule (posterior capsule), accumulate, and cause the membrane to become opaque. As a result, the capsule allows less light to pass through to the retina, causing cloudy vision.
Signs of a Secondary Cataract
The signs of posterior capsular opacification match those of a cataract. They include:
- Gradual decline in vision
- Halos and glare
- Cloudy or blurred vision
- Sensitivity to light
- Poor night vision
- Colors appearing faded
- Double vision in one eye
For some people, a secondary cataract becomes very dense, causing more vision loss than the original cataract.
Secondary Cataract Treatment
Just like a cataract, you should have a secondary cataract treated if you:
- Are unable to complete simple, everyday activities or enjoy your hobbies because of vision problems
- Have difficulty driving at night because of poor vision
- Have another sight-threatening eye condition
The best way to treat a secondary cataract is with a YAG capsulotomy. A YAG capsulotomy is a quick, painless procedure that takes under 10 minutes.
What to Expect During a YAG Capsulotomy
First, you’ll receive anesthetic drops to numb your eye so you won’t feel pain. Your pupil will also be dilated using special drops.
Next, your surgeon will place a special contact lens to prevent blinking and allow for greater precision when focusing the laser beam. He will then use a YAG laser to create a tiny hole in the center of the lens capsule at the back where the cells have built up.
No incisions are required to access the back of the lens capsule. The opening made by a YAG laser lets light pass through, restoring clear vision. A YAG capsulotomy is an effective and safe procedure that rarely needs repeating.
The same-day procedure takes approximately 5 to 7 minutes to complete.
Recovery After a YAG Capsulotomy
After having a YAG capsulotomy, you may need to arrange for someone to drive you home. You might notice your vision is blurry for a few hours following your procedure as on average, it will take about 3 hours for the dilating eye drops to wear off.
The blurry vision will resolve independently as the eye drops wear off. Your vision usually improves within 24 hours of undergoing the procedure. Some people see floaters that generally improve in the first few weeks after laser treatment.
You’ll return for follow-up appointments after your YAG capsulotomy to ensure your eye is healing properly in one to two weeks. You can resume your routine as directed by your eye doctor.
Second Opinion Consultation
If your ophthalmologist determines you have posterior capsular opacification and need a YAG capsulotomy, you can get a second opinion. Getting a second opinion will allow you to discuss and weigh the benefits and risks of the procedure in further detail.
A second opinion from an experienced ophthalmologist can enable you to make a well-informed decision about your eye care. When getting a second opinion, your ophthalmologist will review your medical history and ophthalmic examination.
Why a second opinion can give you confidence before YAG laser treatment.
The eye doctor may also recommend additional examinations and testing if they consider them necessary to obtain further information and confirm your diagnosis.
Get a Second Opinion from Desert Vision Center
If your eye doctor has said you need a YAG capsulotomy, getting a second opinion from Dr. Tokuhara will put your mind at ease. After reviewing all the required medical information, specialized test results, and examination, Dr. Tokuhara will discuss the findings with you, determine if you need a YAG capsulotomy, and offer recommendations.
Do you need a second opinion? Schedule your appointment today at Desert Vision Center in Rancho Mirage, CA, now!
You never need to have cataract surgery a second time. If your vision becomes cloudy again months or years after cataract surgery, it is almost always a secondary cataract (posterior capsular opacification). This is not a true cataract and is easily corrected with a quick, painless YAG laser capsulotomy – no incisions, no stitches, and no downtime. Within minutes, your clear vision is restored.
Not sure if your vision change is a secondary cataract?
Do you need a second opinion? Schedule your appointment today at Desert Vision Center in Rancho Mirage, CA, now!