Secondary Cataract Treatment - Posterior Capsulotomy

A posterior capsulotomy is a laser procedure that may be necessary after cataract surgery. It is performed to treat secondary cataract.

During cataract surgery part of the front (anterior) capsule that holds the lens is removed. The clear back (posterior) capsule is left in place. In up to 10% of people, the posterior capsule loses its clarity; this is referred to as a secondary cataract. When a secondary cataract develops, an opening can be made in the capsule with a laser (posterior capsulotomy - image on right) to restore normal vision. It is not possible to predict at the time of cataract surgery if, or when, this procedure will be required, however it is known that certain types of cataract are more likely to result in secondary cataract.

Before the laser procedure, a thorough ophthalmic examination is performed to make sure there is no other reason for blurring of vision.

A posterior capsulotomy is painless and takes five minutes. The pupil is dilated ahead of time and drops are placed in the eye before and after the procedure to prevent an increase in eye pressure. A focused light beam (laser) is used to painlessly open a window out of the cloudy capsule for the patient to see through. Vision should improve over 1-2 days. The eye must be checked one week after the procedure to ensure proper healing.

After laser capsulotomy: notice the window that is cut out of the film, allowing clear vision.

Potential but rare complications following laser posterior capsulotomy are increased intraocular pressure and retinal detachment. There is a 1 in 10000 chance that the cataract would reform, requiring a repeat capsulotomy. The procedure is covered by OHIP.