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Can cataracts come back after surgery?

Ophthalmologist displays a model of an eye.

Clouded vision after cataract surgery

Cataracts cannot come back after they have been removed. Successful cataract surgery removes the eye’s cloudy natural lens and replaces it with a clear artificial lens. But sometimes — weeks, months or years later — a person’s vision slowly grows blurry again. 

This is not another cataract. It’s a clouding of the natural capsule behind the lens, and it can be treated with a simple laser procedure in the doctor’s office. 

Can my cataract come back after surgery?

A cataract occurs when fibers and proteins in the lens of the eye begin to break down. Over time, these proteins and fibers cloud the natural lens and cause vision to become blurry. 

During cataract surgery, the entire lens is removed, and an artificial intraocular lens (IOL) is implanted. This artificial lens is transparent, and remains so. Because there is no natural lens left in the eye, a cataract cannot come back. 

What is a secondary cataract?

A secondary cataract is a clouding of the natural capsule in the eye (the posterior capsule). It can seem similar to a cataract, but it isn’t one. Your natural capsule holds the new, artificial lens in place following cataract surgery. 

Weeks, months or even years after surgery, this natural capsule can become cloudy. The medical term for this is posterior capsule opacification (PCO).  

Why do I feel like my cataract came back?

The symptoms of a cloudy capsule are similar to those of a cataract. Like a cataract, these symptoms can be slow to develop and may not be noticeable at first. Symptoms include:

Why do people get secondary cataracts?

Even though your doctor thoroughly cleans the interior of your eye during surgery, it’s impossible to remove every microscopic lens cell, and some cells are left over. These cells can begin to grow and form a kind of scar tissue that may eventually cover the capsule, creating the “secondary cataract.” 

This occurs in up to 50% of patients somewhere between two and five years after cataract surgery.  

How do you treat a secondary cataract? 

To treat a secondary cataract, your ophthalmologist can perform a YAG laser capsulotomy with a laser instrument in a short office procedure. The laser will create an opening in the capsule so that light can reach the retina again and visual clarity returns.

What is a posterior capsulotomy? American Academy of Ophthalmology. October 2020.

Posterior capsule opacification. Experimental Eye Research. February 2009.

Posterior capsule opacification EyeWiki. American Academy of Ophthalmology. June 2021.

Posterior capsule opacification. Kellogg Eye Center. University of Michigan. March 2015.

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