Many cataract patients have this question: after cataract treatment, will it come back in the future? In the clinic, we meet some patients who have received cataract surgery, but after half a year, one year or even two years, they can’t see clearly again, and the symptoms are exactly the same as when they got cataract. The doctor will say to the patient that your “cataract” has grown back. When the patient hears this, he often doesn’t understand: I have already been treated after surgery, how can I have a cataract again? What if it comes back after treatment? With these questions in mind, let’s understand what “posterior cataract” is all about.
Posterior cataract refers to the proliferation of epithelial cells in the posterior capsule of the lens after cataract surgery, forming a translucent or even dense mechanized film in the pupil area, which affects light transmission and leads to vision loss.
A key structure during cataract surgery is the “capsular bag”. During surgery, we remove the white cloudy material from the capsule and keep the capsule, placing the IOL inside the capsule (as shown in the figure).
However, at the edge of the capsule, there are still cells that cannot be removed. After surgery, when the cells are more active, they will slowly proliferate along the capsule and eventually form a dense mechanized film on the posterior capsule, resulting in vision loss (as shown in the figure).
With the continuous development of IOL design and materials, the incidence of posterior cataracts has been significantly reduced. However, it still occurs in a subset of patients. The younger the patient, the higher the probability of developing posterior cataracts, and the older the patient is, the lower the probability of developing posterior cataracts because the cell proliferation capacity is reduced.
Some people may say, “I’ll have cataract surgery when I’m 80 years old. This is not necessary at all. Untreated cataracts can have many negative effects and even serious complications. In fact, the treatment of posterior cataracts is very simple. It is a simple operation that can be done in 5 minutes. Moreover, after laser treatment, posterior cataract can be completely cured and there will be no possibility of recurrence. Therefore, cataract “recurrence” is not a scary thing. The doctor will give you the best treatment plan with regular follow-up.