Secondary Cataracts

(Posterior Capsulotomy for Secondary Cataract)

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) to restore normal vision. Some patients have cloudiness of the capsule pre-operatively along with cloudiness of the lens. Those patients can undergo laser capsulotomy as soon as two months after cataract surgery. In the rest of the patients, it is not possible to predict at the time of cataract surgery if, or when, this procedure will be required.

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 after the procedure to ensure proper healing and eye pressure.

Patients can expect to notice little black spots, called floaters, after the procedure. Potential but rare complications following laser posterior capsulotomy are increased intraocular pressure and retinal detachment. There is a 1 in 10,000 chance that the film returns, requiring a repeat capsulotomy.

The procedure is covered by OHIP.