Why does the capsule become cloudy after surgery?
When removing a cataract, the surgeon opens the anterior capsule of the lens, removes the cloudy contents, and leaves the capsular bag itself - an artificial lens is installed in it. Along the edge of the sac, epithelial cells that are capable of dividing are preserved. Over time, they migrate to the back wall of the capsule and form a film or small translucent balls. Optically, it looks like frosted glass in front of the lens. The process is natural, it does not mean the surgeon made a mistake and is not related to what the patient did after the operation.
- Fibrous type - a dense film of connective tissue
- Proliferative type - clusters of cells in the form of balls
- Develops more often in young patients
- Diabetes mellitus and uveitis accelerate the process
- Sharp edge lens design reduces risk
How does it manifest itself?
Complaints increase gradually, so a person often chalks them up to fatigue or bad glasses. Vision seems to be covered with a veil, letters lose contrast, and pronounced flare appears in the sun and oncoming headlights. Sometimes the perception of color changes: shades become duller. The other eye can see noticeably better, and the difference becomes obvious when trying to close one eye. There is no pain or redness with secondary cataracts; their appearance indicates another problem.
- Fog or veil before the eye
- Reduced contrast and clarity
- Glare and halos around light sources
- Deterioration of vision at dusk and while driving at night
- The glasses I picked earlier no longer help
Examination by an ophthalmologist
The diagnosis is made at the appointment. The doctor checks visual acuity with and without correction, measures intraocular pressure and examines the eye at the slit lamp after dilating the pupil - the clouded capsule is clearly visible behind the lens. Be sure to evaluate the condition of the retina and optic nerve so as not to miss macular edema or glaucoma, which give similar complaints. If the cloudiness is so dense that the fundus of the eye cannot be seen, an ultrasound examination of the eye is prescribed.
- Visometry and autorefractometry
- Slit lamp biomicroscopy with pupil dilation
- Measuring intraocular pressure
- Fundus examination
- Ultrasound of the eye, if the fundus is not accessible for examination
- Optical coherence tomography of the retina according to indications
Laser dissection of the posterior capsule
The main method of treatment is laser dissection: a round hole is created in the center of the clouded capsule in the optical zone, and light again freely enters the retina. There are no incisions, the eyes are not opened, the procedure is done on an outpatient basis after instilling pain-relieving drops. It lasts several minutes, the patient sees flashes and hears clicks, but does not experience pain. Vision usually improves the same day or within a few days. The capsule does not become cloudy again, because it is no longer in the optical zone.
- Performed on an outpatient basis, hospitalization is not required
- Pupil dilation with drops is required before the procedure
- After the procedure, anti-inflammatory drops are used for several days.
- In the first hours, floating spots are possible - they usually go away
- A follow-up examination will be scheduled in the coming days.
- If vision is stable and there is slight blurring, observation is possible
What is important to know after treatment
Secondary cataracts do not return, but the eye continues to live its own life, and preventive examinations remain necessary - especially with diabetes, glaucoma and high myopia. In rare cases, after discission, intraocular pressure increases or swelling of the central zone of the retina develops, so the doctor monitors the condition in the coming weeks. After the procedure, glasses sometimes require a new check: the changed clarity can change the usual parameters. If after some time vision deteriorates again, the cause is sought in the retina and optic nerve.
- Do not rub your eyes or lift heavy objects in the first days
- Follow the prescribed drop regimen
- Contact urgently for flare-ups, “curtain” and sharp pain
- Have a fundus examination at least once a year
- Control blood sugar and blood pressure
- Select glasses no earlier than vision stabilizes
