The Cat(aract) Came Back. What May Cause Blurred Vision After Cataract Surgery and how a Laser Can Help.

The other day a patient was sitting in a chair a year after cataract surgery in both eyes.  She read 20/20 minus a few letters in the right eye and was exclaiming how fantastic her vision was; she never had this kind of vision as a youth.  Then she changed over to check the left eye and she was struck by how blurred the letters appeared when compared with the vision in her right eye.  Her vision tested at around 20/40 in the left.  Troubled she asked the question, “Did my cataract come back?”

The first thing she needed to be clarified on is what a cataract really is.  A cataract is a clouding of the natural lens of the eye.  It can be a congenital condition, effects of certain medications, trauma, or the aging process.  Once a cataract has become significant enough that it affects a person’s daily life or hinders a person from enjoying their hobbies due to poor vision, it is time to consider cataract surgery. 

 

photo credit: imgarcade.com  

 

Today, cataract surgery is accomplished very quickly with a speedy recovery period and minimal discomfort.  The lens of the eye sits in a thin bag inside the interior of the eye called the capsule.  An incision is made in the cornea either by hand or by laser, the surgeon then opens the capsule, breaks apart the hardened lens and replaces this with a clear artificial lens inside the capsule.  There are a variety of options out there and you should speak with your Ophthalmologist’s office for more insight into these options.   These artificial lenses cannot develop cataracts. 

 

What then could cause the patient’s blurred vision?  In a small percentage of patients, the cells that are left inside the posterior portion of the capsule begin to multiply causing an opacity that will blur vision.  This condition is sometimes referred to as an “after cataract”.   Luckily, a laser procedure is done to break apart this clouding and restore cleared vision.

Photo credit: OpthoBook

(Image is lens and capsule seen from side view.)

If you thought cataract surgery was fast and painless get ready for the ease of a YAG laser procedure.  A numbing drop is instilled about a half hour prior to the procedure as well as a dilating drop so the laser can enter through the pupil of the eye.  A second numbing drop is administered, the patient places their head in the laser machine and after just a few seconds and a few zaps the cells are obliterated. 

 

Directly after the procedure intraocular pressure is checked to ensure it has not spiked and the patient is sent home.  Vision generally clears within the next couple of days.