Posterior capsular opacification

Pictured above is a retroilluminated image of a lens implant with frosted glass like thickening and clouding of the posterior capsule, seen against the red glow inside of the pupil.

 

The delicate <10 micron thick lens capsule is one thing ophthalmologists strive to protect during cataract surgery. Preserved intact, this is the best home for the new intraocular lens implant to securely reside. Post operatively the capsule will be crystal clear. 

In around 20% of patients, a few years later, the capsule can gradually become hazy. It occurs as the equatorial part of the capsule naturally produces new cell fibres throughout life, but these sometimes proliferate and behave in a scarring manner. A slow visual deterioration will be noted, similar to when the cataract first formed. The good news is that there is a straight forward one time only fix.

YAG laser capsulotomy is a technically precise, though quick and painless procedure undertaken in an outpatient setting with anesthetic eye drops and a magnifying contact lens. A small pupil sized opening is created in the opaque capsule just behind the lens implant. Vision is rapidly restored and risks are extremely rare.

 

Treatment is to be recommended at the point when blurring of vision is affecting quality of life.