Posterior Capsule Opacity

What is Posterior Capsule Opacity?

Let’s imagine an analogue of an egg wherein eggshell as lens capsule with its egg white plus egg yolk as natural lens. If the anterior or front portion of the egg is carefully cut through incisions to extract the egg white and yolk then the back portion or posterior end is retained intact.

In a similar manner during a cataract surgery your natural lens are removed from the anterior position of the lens capsule and further implanted with IOL. The posterior position of the lens capsule is kept purposely kept intact to hold the IOL in its position. The opacity or blurring of the posterior capsule which holds the lens is called Posterior Capsule Opacity. This could occur as the outer cells of the natural lens remain in the membrane and grows on the capsule making it progressively thick and opaque. It is commonly known as ‘secondary cataract’ or ‘after cataract.

The commonly known two forms are fibrous and pearl or a combination of both. Posterior Capsule Opacity is a known complication after a cataract surgery. Some symptoms are pretty similar to that of cataract and apparently you may feel like the re-occurrence of cataract.

Symptoms:

  • Vision becomes hazy and blurred.
  • Glares occur.
  • Difficulty in reading small print.
  • Gradual decrease in vision.

Causes:

  • Use of surgical techniques– Single piece lenses are used extensively compared to three piece lenses. The variation in sizes and certain surgical techniques can cause Posterior capsule opacity.
  • Intraocular lens optic edge designs– Comparatively Square and sharp edge designs in IOL aids In preventing Posterior Capsule Opacity as it arrests the movement of lens cells migrating behind the lens.
  • Intraocular lens materials- The biocompatibility of IOL materials usually made of silicone or acrylic polymers. Depending on the type of material the cell inflammation can increase or decrease leading to Posterior capsule opacity.
  • Other causes include the Use of therapeutic agents, Patients age, Inflammation in the eye after surgery, Duration of time since the surgery.

Diagnosis:

During a routine eye exam your eye pupils would be dilated to detect Posterior Capsule Opacity along with OCT (optical coherence tomography)). It could become severe if you have diabetes or uveitis. Risk factors are modifiable through surgical techniques. Based on the diagnosis you would be advised necessary treatment.

Treatment:

YAG laser capsulotomy: This is a safest, painless and effective outpatient procedure to restore vision. It is painless since the capsule bag does not have any nerves in it. Ensure that you remain still during the procedure which lasts for few minutes. In this procedure a small opening is created by using laser. Further the laser removes the affected portion of the posterior capsule from your line of sight. During this process no incision are made. Normally when laser is fired you may hear a clicking sound with a few light flashes. Owing to the absence of incisions the risks are minimal. Nevertheless in rare cases Retinal detachment (the retina loses connection with the inner back of the eye), movement of the lens implant or retina may develop swelling etc. are rare complications in YAG laser capsulotomy.

You are advised rest at the hospital for few hours to ensure that eye pressure is under control and to instill eye medication.

After undergoing YAG laser capsulotomy, your vision is expected to be normal after a day. You could resume normal activities quite immediately.

In case you experience no improvement in vision or any other discomfort like pain etc., do get in touch with us at the earliest.

New advances in IOL technology and surgical techniques, vision researchers are investigating on solutions to combat Posterior Capsule Opacity and optimize visual outcome.

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