Can Cataracts Come Back After Surgery?

4 min read

You may read about something called a secondary cataract. Because of this terminology, many people wonder, "Can cataracts come back?" The scientific answer is no. Once a cataract is surgically removed from your eye, it can not return. You can not get a cataract twice in the same eye. There are other things that can happen which may require further intervention by your doctor but it is not possible for the cataract to return. In order to understand this, let's first talk about what a cataract is.

What Is A Cataract?

A cataract is a normal aging change of the eye's natural lens. Most people in the world are born with a natural lens in each eyeball. This lens focuses light onto the retina so that you can see. As a person gets older and ages, the lens ages also. This causes the lens to become less clear. This makes a person's vision also less clear. In order to remove the cataract, the natural lens of the eye is removed and a new artificial lens is placed inside the eye. Because the cataract is removed in its entirety there is no way for it to come back. The new artificial lens does not age the way your natural lens ages, so the new lens can not develop a cataract.

Blurred Vision After Cataract Surgery

If a patient has blurry vision after cataract surgery, there could be a few things going on.

The first is that there may still be inflammation inside the eye. Inflammation in the eye after cataract surgery is normal. Your ophthalmologist will give you eye drops to take to reduce this inflammation. Sometimes the inflammation can linger longer than expected and it can cause blurry vision.

There can also be some swelling in the retina after cataract surgery. This is more likely to happen to you if you are a diabetic. It is also more likely to happen if your diabetes is not well controlled. There are medications that can help to reduce this swelling.

After cataract surgery, your prescription is likely to change, so your blurry vision could be due to this. One to two months after cataract surgery, your doctor can give you a new eyeglasses prescription.

What Is A Secondary Cataract?

Another common occurrence after cataract surgery is the development of something called a posterior capsular opacification. This is what people mean when they talk about a secondary cataract. It is a bit of misnomer, however, because it is not actually the same as a cataract. A posterior capsular opacification happens behind the artificial lens in a part of the eye called the capsular bag. The posterior capsule of this bag becomes hazy due to cellular proliferation of lens epithelial cells after cataract surgery. Luckily, there is a quick solution to this. The eye surgeon who performed your cataract surgery can also perform a laser to eliminate this opacification. While it is a relatively safe procedure, there is a small risk of retinal problems after this laser so it is important to chat with your ophthalmologist about the risks and benefits of having it done.

Can Cataracts Come Back After Surgery: Take Home Points

Can you get cataracts twice in the same eye? No. Once surgically removed, a cataract can not come back. If part of the cataract was left behind during surgery, it may need a second procedure to remove it, but a new cataract will not form. A PCO, or posterior capsular opacification, may form and this can be lasered by a Board Certified Ophthalmologist. While a PCO is often referred to as a secondary cataract, it is not the same thing as a cataract since it is not an aging change of the lens and happens in a different part of the eye called the posterior capsule.

Sources:

Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar-Gomez M, Ram J, Auffarth GU. Eradication of Posterior Capsule Opacification: Documentation of a Marked Decrease in Nd:YAG Laser Posterior Capsulotomy Rates Noted in an Analysis of 5416 Pseudophakic Human Eyes Obtained Postmortem. Ophthalmology. 2020 Apr;127(4S):S29-S42. doi: 10.1016/j.ophtha.2020.01.026. PMID: 32200823.

https://pubmed.ncbi.nlm.nih.gov/32200823/

Wormstone IM, Wormstone YM, Smith AJO, Eldred JA. Posterior capsule opacification: What's in the bag? Prog Retin Eye Res. 2021 May;82:100905. doi: 10.1016/j.preteyeres.2020.100905. Epub 2020 Sep 22. PMID: 32977000.

https://pubmed.ncbi.nlm.nih.gov/32977000/

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