Introduction
It is the secondary cataract or scarring that causes cloudy vision post-cataract surgery. The term posterior capsular opacification (PCO) has been regarded for this condition. Following recovery, a patient might be able to see again. However, a few weeks or years later, a person might tend to develop PCO. It has emerged as the most common complication post-cataract surgery. This affects about 20 to 50 percent of the patients who tend to develop PCO within about two to five years after the cataract surgery. Young age is considered a risk factor for developing this condition. Young children are found to be the most susceptible. Newer cataract surgeries have tried to reduce the risk of developing this condition but have failed to eliminate its occurrence. Other associated symptoms of PCO include reduction in contrast sensitivity, lack of binocular vision, and halo effect.
Is Cloudiness a Normal Part of the Healing Process After Cataract Surgery?
Cloudiness is a normal part of healing post-cataract surgery, regarded as “posterior capsular opacification” (PCO) or secondary cataract. During the cataract surgery, the cloudy natural eye lens is removed and replaced by an artificial lens called an artificial intraocular lens (IOL). In some cases, clouding of the back part of the lens capsule can be seen over time, which results in temporary blurring of vision. PCO can take weeks, months, or years to occur. It is not a recurrence of cataracts but rather a treatable side effect. The cloudiness mainly results from wrinkling and thickening of the lens capsule.
When Must a Patient Contact the Doctor for Cloudy Vision?
A patient must talk to an optometrist or an eye doctor, even if the condition seems to have developed over the years. They can help determine if the persisting condition is PCO. After cataract surgery, the patient must follow all the instructions given by the doctor to help aid in recovery. In case of continuous persistent symptoms like hazy vision, shadows, starburst patterns around lights, halos, and glares, the patient must consider contacting the doctor. Some degree of cloudiness post-surgery is normal, which might improve gradually. Still, the doctor must be contacted immediately in case of the symptoms mentioned above.
What Are the Symptoms and Causes of Posterior Capsular Opacification?
The symptoms of posterior capsular opacification include:
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Cloudy, blurred, and a fuzzy vision. It might seem like looking through frosted glasses.
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Glaring and halos around lights.
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Light sensitivity.
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Trouble in reading.
These symptoms resemble typical cataract symptoms before surgery. The cause remains of the leftover epithelial cells once the eyes' natural lens is removed during cataract surgery. These cells travel and get collected on the surface of the lens capsules. It is part of the body’s natural defense mechanism. As these cells continue to build up, they cause the capsule to become cloudy, which is otherwise totally clear. This cloudiness affects the ability to see with eyes, as seen normally.
What Are the Risk Factors for a Secondary Cataract?
The risk factors for secondary cataracts include anyone who has undergone cataract surgery and is at risk of developing secondary cataracts. However, the risk remains higher amongst people having the following conditions:
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Diabetes-related retinopathy.
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Nearsightedness.
A higher risk is faced if eye swelling persists during or soon after the cataract surgery.
Can the Type of Intraocular Lens (IOL) Used During Cataract Surgery Affect the Likelihood of Experiencing Cloudiness?
The intraocular lens (IOL) type can influence and increase the likelihood of experiencing cloudiness, especially PCO. Certain characteristics of the lens influence the rate at which it develops. The standard IOLs may be associated with a higher incidence of FCO, and these lenses are usually made of silicon materials. Those IOLs with acutely edged designs contribute to a higher risk, whereas the square-edged IOLs reduce the risk of the same. The placement of the IOL in the posterior chamber also affects the likelihood of PCO. It is important to go ahead with technological advances like square-edged designs, hydrophobic materials, and improved surgical techniques, which have significantly contributed to the reduced incidence of PCO. Ultimately, IOL is a decision between the patient and the treating doctor, considering the patient’s needs, lifestyle, and potential complications. A regular follow-up appointment with the eye surgeon allows for monitoring the postoperative outcomes.
Is Cloudiness Always a Sign of a Complication?
Cloudiness in the vision is only sometimes a sign of complication. It could also be a normal part of the recovery process. Mild haziness or cloudiness is usually quite a common post-cataract surgery. Initial cloudiness is typically due to residual swelling, inflammation, or air bubbles in the eyes, which is not a cause of concern. But PCO, which is also a normal part of the healing process regarding surgical error, is not a complication. PCO can cause gradual clouding of vision and is a treatable condition. The sudden severe cloudiness might also be accompanied by pain, increased redness, and other symptoms, which the doctor must promptly evaluate. Regular follow-up care with the eye surgeon is crucial for monitoring the healing process and must be addressed in case of any concern.
How Can PCO Be Diagnosed and What Treatment Options Are Available?
A careful eye examination is done to diagnose this condition, which includes a slit lamp examination. The painless test provides a closer look at the patient’s eyes. Diagnosis is also reached by recording the medical history of eye surgery. The treatment offered is with the help of a Yttrium aluminum garnet (YAG) laser capsulotomy. This is a laser procedure that is performed in the office. During this procedure, the eye is numbed with the help of eye drops, and a laser is used to make a tiny hole in the cloudy lens capsule. This hole allows light to pass through the IOL, as it should and gives the clear vision back.
Conclusion:
There is nothing that can be done to prevent secondary cataracts. However, researchers are making efforts to look into new surgical procedures and IOL technologies to lower the risk to patients. But yes, with treatment, it will go away quickly and become clear after 24 hours post-laser surgery.
