Secondary Cataract

You are suffering from an opacification of the capsule of your lens, responsible for a decrease in visual acuity and a difficulty in monitoring your fundus. A laser treatment (capsulotomy), which is a means of improving your vision, is proposed to you.

This sheet contains information on the operation, its results and its risks.

Posterior capsular opacification (sometimes called secondary cataract)
This is not a “regrowth” of the cataract but a loss of transparency of the natural lens capsule behind the implant (or artificial lens).

Capsular opacification occurs in over 30% of cases in the years following cataract surgery. Your surgeon has deliberately left the capsule of your lens in place to support the lens implant that replaces the natural lens.

Why treat with laser?
Because eye drops cannot cure a secondary cataract.
The laser is the technique of choice, practised without incision: it is the “capsulotomy with the Nd-YAG laser” which makes it possible to release the opacities of the visual axis by opening the opacified membrane in its centre by laser impacts of controlled power.

Modalities of the procedure :
The procedure is performed on an outpatient basis
The patient sits in front of the device and must avoid moving by keeping his head pressed against the support provided for this purpose.
The laser treatment is quick and painless. A single session is usually sufficient.

Intraoperative incidents or difficulties:
These are rare:
Vagal malaise may occur during treatment, or immediately afterwards.
Glare and discomfort due to possible dilation of the pupil should be avoided for the first three hours after treatment.

Usual postoperative course:
Visual recovery is rapid, often noticeable by the next day.
The perception of flying flies and increased sensitivity to light may be observed for a variable period.
A certain degree of irritation or inflammation of the eye and a transient rise in intraocular pressure are frequent and can be prevented by the treatment with drops prescribed for a variable period of time; the care is reduced to the instillation of these eye drops and the possible taking of tablets, instructions which will be specified on the prescription of your ophthalmologist

Complications of laser capsulotomy :
These are rare.
Moderate ocular inflammation may occur, rarely significant or prolonged.
A lasting rise in intraocular pressure is exceptional. It leads to consider an adequate treatment.

Retinal complications, often of delayed appearance, more frequent in cases of retinal fragility (for example: high myopia) and likely to lead to a drop in vision, require a rapid consultation with your ophthalmologist:
– central retinal oedema (less than 1% of cases) or aggravation of a pre-existing macular disease, announced by visual fog or image distortion
– posterior vitreous detachment and/or retinal detachment, heralded within a variable time frame by new floaters, haze or the sensation of light flashes. An alteration of the optical part of the implant affected by a few laser impacts, without visual consequences in the vast majority of cases.

Displacement of the artificial lens implanted during the initial operation is exceptional and is indicated by a drop in vision. It may require a re-intervention.
Recurrence of capsule opacification is rare: it requires a new laser session or a new operation.

Ophthalmologist in Brussels and Namur


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