Posterior Capsule Opacification

A posterior capsule opacity is the presence of a hazy membrane (capsule) just behind an intraocular lens implant. This condition is sometimes referred to as “secondary cataract,” although the term is actually a misnomer. Once a cataract is removed, it does not recur.

Ophthalmologists generally prefer, at the time of cataract surgery, to place the intraocular lens implant in the same anatomical position that the natural lens (cataract) had, i.e., within the capsular bag.

The lens capsule is the thin, elastic-like bag that holds the intraocular lens (IOL) in position after cataract surgery. During the operation, the front (anterior) portion of the lens capsule is carefully opened and the cataract is removed. The IOL is inserted into the capsular bag, leaving the posterior portion of the capsule intact.

The remaining portion of the capsule becomes clouded in about 25% of cataract surgery patients. When this occurs, patients experience symptoms similar to those from the original cataract. That’s why posterior capsule opacification is also known as secondary cataract.

Signs and symptoms

  • Gradual decrease of vision
  • Blurred vision
  • Glare from lights and sun

Detection and diagnosis

Dr Joseph can diagnose posterior capsule opacification during a routine eye exam using a slit lamp microscope. It is more easily detected if the pupil is dilated. Potential acuity testing is often performed to determine the expected improvement of vision.

Treatment

A simple procedure called a YAG posterior capsulotomy is performed to restore vision lost from the clouded capsule. The YAG is a type of cold laser used to create a small opening in the centre of the posterior capsule, allowing a clear area for light to enter the eye. The procedure is painless, requires no anaesthesia, and has very little risk since no incision is required.

After the dilating drops wear off from the procedure, most patients notice an immediate improvement in vision. The improvement each person experiences is dependent on the extent of the capsular clouding and the overall eye health.

You will be given a bottle of anti-inflammatory drops to instill 3 times per day in your eye for a duration of one week after the capsulotomy.