Why do Intraocular lenses fail a few years after cataract surgery and implants?

Doctor's Answers (1)

Intraocular lenses (IOL) rarely fails a few years after cataract surgery and implants. However, a significant proportion of post-cataract surgery patients may encounter a condition called "posterior capsular opacification (PCO)" which causes cloudiness of vision.

How does Posterior Capsular Opacification occur?

During cataract extraction surgeries, the "nucleus and cortex" i.e. the core content of the cataract are removed through the front leaflet of the transparent capsule, on which a circular opening of about 5mm had been made (either with forceps or with e.g. a laser).

The rest of the capsule is left behind. The IOL is then placed inside the capsule (which now consists of a back leaflet and a 360 degree rim that extends about 2-3mm to the front surrounding the front circular opening. The back capsule can become cloudy over time from growth of some remaining lens cells. 

Certain lens designs are better than others in preventing the growth of these lens cells that can cause PCO.

Treatment of Posterior Capsula Opacification 

The treatment for PCO in general is a quick, fuss-free, painless and safe YAG laser procedure done with dilation of the pupil. This is especially so when the YAG laser is performed carefully, Also, it is important that it is performed earlier when the PCO is not overly thick.

A thicker PCO will require more laser energy, possibly causing a higher risk of problems from laser vibrations transmitted to the retina at the back of the eye (e.g. retina tear). 

In fact, these few days I had performed several YAG laser for PCO, all lasting just about 3 minutes. The laser procedure is an outpatient treatment done in clinic. No post-laser eyedrops nor extra hygiene care is required, apart from a repeat check-up with dilation of the eye after several weeks.

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