First, let’s understand the anatomy of the lens and cataract surgery: The lens is the equivalent of a convex lens and is composed of the capsule and the cortex and nucleus within the capsule, which is divided into an anterior capsule and a posterior capsule. To use a less appropriate analogy, it is like an egg with a shell, white and yolk. A cloudy lens is called a cataract.
Cataract surgery involves tearing open the anterior capsule of the lens through a 2-3mm incision with a diameter of about 5.5mm (like opening a can), emulsifying, crushing and suctioning out the cloudy nucleus and cortex with ultrasound emulsification, and finally implanting an artificial lens inside the capsule bag.
Due to the presence of this bag, the lens cells under the anterior capsule will proliferate and migrate to the posterior capsule, thus causing the clouding of the posterior capsule. This is what our doctors call “posterior cataract” or “posterior capsular clouding”.
Posterior capsular clouding is one of the common long-term complications after cataract surgery, mainly related to the time and age after cataract surgery, the older the age, the lower the incidence, the longer the time after surgery, the higher the incidence, the incidence of the elderly is about 20%. The incidence is higher in children, almost 100%, so preventive measures, namely central posterior capsular membrane excision and anterior vitrectomy, are used at the time of surgery for children under 8 years of age.
What should I do if a posterior capsular clouding occurs? For the vast majority of patients, it is very simple to deal with this problem, and a YAG laser strike in an outpatient setting is all that is needed without any pain and is convenient. For children who cannot cooperate, they can be hypnotized first and then treated with the laser. For individual patients with thickened posterior capsule, the laser cannot penetrate the posterior capsule and a secondary surgery is required.