Secondary cataract


Secondary cataract is the term used for posterior capsular opacification (PCO).

PCO is a not uncommon condition that can occur after cataract surgery. This can occur months to years after surgery.

It is simply the formation of a layer of lens cells on the back surface of the capsule in which the artificial lens is sitting.

The image above shows an artificial lens with posterior capsular opacification.

Invariably, there are lens epithelial cells which remain in the eye after surgery. It is impossible to remove every last cell during surgery. If there are enough of them remaining, they can replicate and form a layer that obstructs vision.

Patients will notice that vision is not as clear as it was after surgery.

There have been many attempts to try to find a way of reducing the incidence of PCO and to date the best result has come from making the intraocular lenses with square, sharp edges. This stops the lens epithelial cells migrating behind the lens.

Other ideas have been tried, including sterile water in the eye after surgery and chemotherapeautic agents such as Mitomycin C. None however have proved successful.

In any event, PCO is benign and easily dealt with by using a YAG Laser to clear the back capsule.


A YAG capsulotomy is a very straightforward, in office procedure to clear the back capsule of PCO.

It usually only takes a few minutes and is painless.

Vision is usually restored back to normal virtually immediately.

As the capsule is cleared, PCO can not recur.

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