THE MOST COMMON COMPLICATION AFTER CATARACT SURGERY: What is Posterior capsular opacification and what do you do about it.
This video will explain what the most common complication after cataract surgery is. This most common complication is called posterior capsular opacification
Posterior capsular opacification is also known as PCO, posterior capsular haze or secondary cataract. It is a common occurance after cataract surgery and affects 20-50% of individuals anywhere from a few months to a few years after cataract surgery. It will cause symptoms that feel like the cataract is returning. It is treated with a Nd YAG laser which will create an opening in the capsule allowing clear vision.
Posterior capsule opacification otherwise known as pco sometimes it's also referred to as post-capsular haze and sometimes it's referred to as secondary cataract. This is the most common complication after cataract surgery and when i say complication i don't mean it as a bad thing it's just something that sometimes will occur in a lot of patients after cataract surgery. Okay so to understand how a pco develops it's important to understand what happens in cataract surgery. As a quick anatomy review we've got the cornea on the front of the eye you got the iris and then you've got the lens. Behind the iris this lens is where we develop cataracts and this cataracts develop when this lens goes from being clear to being cloudy and that's what the surgeons remove and replace when they're doing cataract surgery. So during cataract surgery the surgeon is going to make a small incision in the cornea they won't remove the cornea but they'll enter in through the that small incision they're going to dilate your pupil so this opening is really really large so they can get access to the lens that's located behind the iris.
Now this lens where the cataract develops this lens sits inside what we call a capsule and now the capsule is a clear bag which holds this lens in place. The cataract surgeon when they do the surgery. The first thing you're going to do is they're going to cut a hole not in your iris your iris is very dilated but they're going to cut a hole in that clear capsule in that bag so they can get access to that cataract. Once they have an opening of that front of the capsule they can go in with an instrument that breaks up the lens and sucks out all the little pieces of that cataract lens and pull them out.
And then you're going to be having remaining that capsule that little bag with an opening in the front and intact in the back and then they're going to take the synthetic lens and they're going to insert that into that bag and so it sits in place and you can see clearly.
So a pco develops when there's a proliferation of lens epithelial cells so what are lens epithelial cells so lens epithelial cells are the cells that grow into parts of the natural lens so the natural lens is actually growing throughout our lifetime it continues growing so it and it develops from these little cells called lens epithelial cells which keep regenerating and regrowing so part of the cataract surgery is when the cataract surgeon they go in and they break up all that lens and that cataract and remove the cataract there will be little epithelial cells remaining and so they work hard to try to clean out those little epithelial cells they're going to use a vacuum or aspirator to suck out all those little cells to have a very clean capsule and then they're going to put that lens implant in place however those lens epithelial cells they're really really tiny and so occasionally there'll be a few that are stuck in little crevices or little cracks that the surgeon can't remove or can't see to remove and what will happen over time is those lens epithelial cells will start to grow and they'll grow along the back side of that lens capsule and eventually they will start to cloud it over and when it starts to cloud over that's called posterior capsule opacification and so basically what happens is that the back of that capsule is starting to become cloudy and you're going to end up with very similar symptoms as when you first start to develop your cataracts so you're going to notice your vision's going to go blurry you're going to notice you're going to get more glare you're going to notice that it's going to become cloudy and this is why it used to be referred to as secondary cataract or a second cataract because it felt like the cataract was coming back we don't use that term anymore because it's not really accurate and it's a little bit confusing to patients because they think all my cataracts are coming back which your cataracts actually can't come back it but it will feel like they're coming back so we will rather use a term called posterior capsular haze or posterior capsule opacification which more accurately describes that that capsule is clouding over
