Answers by Mitchell Gossman, MD, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud
Can a cataract grow back after cataract surgery?
In a way, yes, but not as you might think.
When cataracts occur, the normally clear lens which focuses light onto your retina becomes cloudy. This lens is right behind the pupil, and when it’s clear, it is not visible externally, such as looking in a mirror.
When the cataract worsens, it starts to create problems like blurry vision -- interfering with work, play, hobbies, reading, television etc. And when driving at night and in bright sunlight, it can cause glare. When this starts to be a problem for you, you can consider having cataract surgery to correct it.
This is a procedure whereby the cloudy lens is removed and replaced with an artificial lens, not a living lens from a donor. These artificial lenses are extremely stable, only rarely becoming cloudy after surgery.
It may surprise you to hear this, but normally, the entire cataract is not removed. The cataract is much like an M&M candy in that it has an outer shell (called the “capsule” which is much like the membrane of an egg yolk), and a chocolate middle (composed of two sections called the “nucleus” and “cortex”). The outer capsular membrane is left behind because it helps support the lens implant and keep it centered.
Inevitably during cataract surgery, some cells from the cataract are left behind, and these may start to grow. They don’t start over and make a new natural lens, like a salamander can with a missing leg, but rather it creates a cloudy film along the back of the artificial lens.
The reason people sometimes think that cataracts can grow back is because the symptoms of this “cloudy capsule” condition are very similar to the symptoms from the original cataract.
Fortunately, you don’t have to go back to the operating room because it is an easier matter to use a laser, right in the office, to cut a hole through this cloudy capsule. There are no nerve endings in there, so there is absolutely no pain with the laser. This procedure is done by an ophthalmologist (a physician specializing in eyes) using a device called a “YAG Laser.”
This condition is very common, and can occur at any time after cataract surgery.
If this cloudy film forms, is this a complication of cataract surgery, i.e. did something go wrong?
Absolutely not, and in fact, needing this laser later in life is a sign that the cataract surgery was performed well. Complications during cataract surgery can damage that posterior capsule and become unable to support a lens implant in the usual way, so if you need the YAG laser after surgery, rest assured it’s not an issue, and is a sign of uncomplicated cataract surgery.
Find out more
Dr. Mitchell Gossman is a comprehensive ophthalmologist at Eye Associates of Central Minnesota. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email firstname.lastname@example.org.
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