Secondary cataract. Treatment and prices. Secondary cataract (secondary) after lens replacement surgery Secondary cataract after lens replacement

Secondary cataract is a pathology that develops in patients after extracapsular extraction of a primary cataract, that is, after removal of the lens of the eye with signs of clouding. In patients with secondary cataract, a slow decrease in visual function is noted, which gradually reduces the positive results achieved from the operation to nothing. This complication usually occurs in 10-50% of patients who have undergone extracapsular extraction.

This disease has many causes. But, as a rule, they act in combination. This means that the development of a secondary cataract requires not only an operation in the lens area, but also any other concomitant factor. By identifying and eliminating it, it is possible to significantly reduce the intensity of the processes that occur in the lens capsule. In this case, treatment should be started immediately, as this will save up to 90% of visual function.

Causes

The primary cause is quite simple: a natural change in the organ of vision due to aging, external influences. Secondary glaucoma is caused by several other factors, including:

Incomplete resorption of the masses of the lens, if one was injured;
Incomplete extraction of parts of the lens during the operation;
Disturbed metabolism and endocrine pathologies;
Autoimmune processes;
High degree of myopia;
Retinal disinsertion;
Inflammation in the area of the choroid of the eyes.

The specific cause can only be determined by an ophthalmologist. Self-treatment of a secondary cataract is fraught with complete loss of vision.

Important! What it is - a secondary cataract, only a doctor will answer you. But it should be understood that despite the progression of the disease, there is a chance to maintain visual function if you consult a doctor in time.

Types of secondary cataract

In general, secondary cataracts are divided like primary cataracts into the same types:

Posterior and anterior subcapsular cataract. The anterior is located under the capsule. The posterior is characterized by the location in front under the posterior capsule. Due to this location, this type most often results in loss of vision. If we compare it with cortical or nuclear cataract, then it has a greater effect on visual acuity in general. But at the same time, patients have residual vision. They see worse with a narrowed pupil, bright light and headlights. To a greater extent, the ability to see suffers in relation to nearby objects.
flutters in those cases when age-related changes occur abnormally. The nucleus of the lens is involved in the process. This type of pathology is almost always accompanied by myopia. In this case, the sclerosis of the nucleus at first may have a yellowish tint, which is caused by the deposition of pigment. When the pathology progresses, it becomes brownish.
With cortical cataract, the posterior, anterior and equatorial parts are covered in whole or in part.
Herringbone cataract occurs in a fairly rare form. The deep layers of the lens suffer from the deposition in them of multiple multi-colored needle-like masses that resemble spruce. That's where the name came from.

How quickly the secondary cataract will progress, as well as how much the lens becomes cloudy - many factors play. In particular, the most significant are the age of the patient, comorbidities and the severity of inflammatory processes.

Important! After IOL implantation, secondary cataracts can significantly affect visual function against the background of improved vision. At the same time, doctors refuse to change lenses again, since this will not solve the problem. It is possible to say which treatment will help only after the examination.

Clinical stages and different scenarios for the development of pathology

If we talk directly about the pathological processes that occur during the development of a secondary cataract, then they proceed in four stages:

Initial;
Immature or swelling;
Mature;
Overripe.

initial stage

The initial stage involves the exfoliation of the fibers of the lens. There are gaps between them. Under the capsule itself, vacuoles gradually form, which are filled with liquid.

It is noted that in patients with a cortical form, complaints are extremely rare. They can talk about a slight decrease in vision, the presence of flies before the eyes, dots or strokes. Nuclear cataract, on the other hand, proceeds quite quickly, worsening central vision. As a result, the lens becomes cloudy. At the same time, distance vision may also deteriorate in parallel. Signs of myopia, if they appear, then for a short period of time.

Such a course leads to the development of ophthalmohypertension, which, in turn, further worsens the condition of the visual apparatus and provokes the accelerated development of pathology. At the same time, if therapy is absent, then glaucoma may also develop. In such cases, there is only one treatment - the complete removal of the lens. Areas in which turbidity is present gradually capture an increasing area and eventually close the pupillary opening. It is at this time that the color begins to change to gray-white. At this stage, visual function declines very rapidly.

mature stage

The mature stage is characterized by a decrease in the lens. Its layers are completely cloudy. He himself shrinks, loses moisture and gradually takes on the shape of a star. The pupil appears cloudy white or bright gray. At this stage, patients cease to distinguish objects. The whole function is reduced to light perception, that is, the patient can see a beam of light, determine where it comes from and distinguish colors.

overripe

An overripe cataract is characterized by complete destruction of the structure of the fibers of the lens body. The whole mass becomes homogeneous. The cortical layer becomes milky, liquid. Over time, it dissolves. The nucleus shrinks, becomes dense and heavy. Because of this, it sinks to the bottom of the chamber, which increases. If surgery is not performed at this stage, then only a small nucleolus will remain, and the lens capsule itself will be covered with cholesterol plaques.

In another variant of the development of the pathology, the proteins of the lens are destroyed, creating conditions for the liquefaction of the lens. The osmotic pressure will begin to rise in the capsule. The core also sinks to the bottom of the chamber, but at the same time it does not harden, but on the contrary, it softens until it completely disintegrates and dissolves.

Secondary cataract

A secondary cataract is essentially an overgrowth of fibrous tissue in the posterior lens capsule. These processes do not begin immediately, but after some time after third-party intervention - trauma, surgery. Since doctors try to preserve the lens chamber for implantation or IOL surgery, over time it can begin to produce lens cells on its own. After the installation of the IOL, a secondary cataract is often observed due to clouding of these same cells with which the body tried to restore the lens fibers. Over time, they begin to become cloudy, which provokes the pathological course of the period after the operation.

In simpler terms, these cells, which were given the name Amaduke-Elsching cells, begin to move. They pass into the central part of the optical region. After that, an opaque film is formed. It is she who reduces visual acuity.

Important! Such a course of pathology after surgery is not the result of the negligence and unprofessionalism of the surgeon. This is an individual feature of a particular organism, the result of cellular reactions occurring in the lens capsule.

Signs of a secondary cataract

If we talk about specific symptoms, secondary cataract manifests itself:

Visual impairment that occurs gradually;
Veil before the eyes;
Illumination near light sources;
Blurred vision.

These symptoms may take years to develop or progress over the course of a month. It depends on the form and concomitant diseases. Only a doctor can tell a more accurate picture and predict the course of the pathology.

Important! Symptoms of a secondary cataract may be similar to other pathologies of the eye. Therefore, before starting treatment, consult your doctor. Often, the disease is hidden behind other diseases, and improper or inadequate treatment will only aggravate the condition of the visual apparatus.

Diagnosis and treatment

Diagnosis involves a series of studies that will help identify the form of the disease. Based on these data, it is possible to decide which treatment will help preserve the patient's vision and eliminate pathological processes. Diagnostic procedures for secondary glaucoma include:

biomicroscopy;
Look through the slit lamp.

Based on the data obtained, it will be possible to determine the type of treatment. Usually, laser or surgical is used, depending on what facilities and equipment the clinic has, as well as on which method is preferable. Laser treatment is more common because it is safer and has fewer contraindications and consequences than conventional surgery.

Laser treatment or discission allows you to cut the posterior lens capsule. Such an intervention is considered the safest and most effective. One has only to take into account that the IOL can be damaged by the laser. Therefore, doctors pre-diagnose, examine and decide which type of procedure is better to use.

It is noted that laser discission is an outpatient intervention, in which the patient does not even need to be given general anesthesia. It is enough to drip instill anesthesia into the treated eye and you can start the operation. The process uses a high-precision laser, which produces a selective effect on the tissue. The cloudy part of the capsule is removed from the back wall.

Important! Before agreeing to an operation, make sure that the clinic has the appropriate facilities and equipment, as well as the experience of the specialists. Otherwise, no one can guarantee the successful course of the operation and the recovery period after it.

The possibility of restoring the original visual acuity is minimal. Usually about 90% of the original vision is restored. Patients after such exposure noted an improvement in visual function almost immediately. Surgery does take some time to recover.

In the surgical type of operation, local anesthesia is also used. At the same time, doctors act on the clouded part of the lens capsule through a micro-incision, removing it. In general, when choosing between a surgical and a laser method, doctors, if possible, try to choose the second option, since it shows greater efficiency, fewer side effects and contraindications.

Medical treatment

Many people want to do without operations for primary and secondary cataracts. Doctors in such cases prescribe medications based on:

Potassium salts;
calcium salts;
magnesium salts;
Yoda;
Hormones;
biogenic preparations;
Substances of plant and animal origin;
vitamins.

This type of treatment at best allows you to slow down the process. It is not possible to eliminate the film formation itself with medication due to the anatomical inaccessibility of this area. Therefore, no one could be cured with such medicines.

Important! For a complete cure, you should consult a doctor and decide whether it is worth the operation. Modern techniques are minimally invasive and, if performed correctly, are as painless as possible. As a result, vision is significantly improved without a massive impact on the tissues.

Predictions for secondary cataract

Predictions for secondary cataracts largely depend on how quickly the patient asked for help. If therapy was started at the very beginning, when vision was just beginning to fall, then there is a chance to stop the pathology with medication or eliminate the resulting protein film in an operative way.

If the patient applied when the symptoms became more intense, then a positive outcome of the operation is guaranteed, but drug treatment no longer gives results in such cases. Surgical or laser treatment can restore up to 90% of visual function.

When addressing in the later stages, it should be understood that the pathological processes have progressed for too long. In such cases, doctors, as a rule, can slightly improve visual function with an operative or laser method, but it will not be possible to completely restore vision. Drug therapy will be relevant only in the presence of concomitant pathologies. At the last stage, complications such as glaucoma often develop, and therefore there is a risk of a complete loss of visual function.

It is worth noting that secondary cataract does not have any preventive measures. The only thing a person can do in such cases is to regularly visit a doctor for medical examinations. If a secondary cataract is detected in the early stages, then there is a chance to stop the pathological process with medication without the development of complications.

It is worth noting that in such cases, medicines will have to be used almost constantly, periodically changing them. A replacement is made so that tolerance to the composition of the funds does not develop. The correct approach to rehabilitation and treatment will allow you to maintain vision for a long period after surgery. after the operation, consult with your doctor about what measures to take to prevent such a development in the future.

Primary cataract occurs due to insufficient nutrition of the lens of the eye. It begins to become cloudy, loses its optical properties, as a result of which a person loses his sight. This pathology is treated by removing the clouded lens and replacing it with an intraocular lens (IOL). This procedure is carried out using various technologies. None of them, even the most modern, can completely exclude the re-development of pathology. Consider its causes and symptoms.

Secondary cataract after lens replacement is accompanied by clouding of not the most transparent body, but the posterior wall of the capsule in which it was located. Gradually, it becomes more dense and ceases to transmit light. This leads to visual impairment. If the disease is not treated, the patient will see worse and worse. However, the disease does not always progress quickly. Ultimately, it always ends in blindness and disability, unless appropriate measures are taken.

Secondary cataract after lens replacement: causes and risk factors

It is difficult to name specific reasons that lead to the development of recurrent cataracts after lens replacement. Pathology can be provoked by metabolic disorders, an unhealthy lifestyle, and injuries. There are several risk factors that can cause the occurrence of secondary cataracts:

Elderly age. The likelihood of developing the disease increases many times if a person is over 60-70 years old. Natural aging of the body and slow metabolism are accompanied by a weakening of the immune system. The eyes receive less nutrients, they weaken, their tissues and cells recover slowly.
Diabetes. Diabetics should constantly be observed by an ophthalmologist, since diabetes mellitus increases the risk of developing many dangerous ophthalmopathologies. Repeated cataract after lens replacement may be the result of a metabolic disorder.
Inflammatory eye diseases, retinal detachment and other ophthalmic pathologies.
Lack of vitamins in the body.

The development of a secondary cataract begins with an increase in the number of epithelial cells on the inner wall of the eyeball. They take up more and more space in the eye and block the passage of light. It is impossible to predict the occurrence of this disease. The only preventive measure is the elimination of certain risk factors. In other words, it is recommended to give up bad habits, strengthen the immune system and see a doctor more often.

How does a secondary cataract appear?

The primary symptom of pathology is a decrease in visual acuity. As the disease progresses, other signs appear:

"flies" before the eyes, flashing sparks, flashes;
blurred vision, veil;
diplopia;
violation of color perception;
blurring of the contours of objects;
focus disorder.

Vision becomes progressively weaker. At the same time, the means of correction do not help to improve it. The first symptoms may appear as early as a few months after the lens has been replaced. In some patients, the pathology slowly progresses for years.

Diagnosis of secondary cataract

During the examination, visual acuity is checked, its boundaries are established using perimetry.

With cataracts, parts of the image may fall out of the view. The doctor will also measure intraocular pressure to rule out glaucoma, which can develop in old age. Through biomicroscopy, the internal structures of the eye are studied. This research method allows you to identify the pathological focus. If macular edema is suspected, fluorescein angiography and optical coherence tomography are indicated. In the presence of chronic diseases, pathologies of internal organs, the patient is sent to the appropriate specialists for additional examination.

Secondary cataract after lens replacement: treatment

The main treatment for recurrent cataracts is discission or capsulotomy. This procedure involves excision of the posterior lens capsule, removing the overgrown epithelial cells that caused the opacification. Previously, capsulotomy was always performed mechanically, that is, with the help of surgical intervention without the use of a laser. This operation is performed on an outpatient basis. It is accompanied by severe injury to the eye, which can lead to complications. The likelihood of their development is much lower when secondary cataracts are treated with laser methods.

Laser dissection is today recognized as the most reliable and safe way to eliminate secondary opacities in the eye. During the procedure, the surgeon makes a hole in the back wall of the capsule with a laser and removes the overgrown tissue. Cleansing lasts 2-3 minutes, and the whole operation - 15-20 minutes.

Who is contraindicated for laser discission?

Firstly, such a procedure is possible only three months after the treatment of primary cataract without removal of the lens and six months after replacement with an intraocular lens. Secondly, laser dissection cannot be prescribed if the following pathological processes are observed:

macular edema;
inflammation of the iris;
proliferation of blood vessels in the pupillary membrane;
swelling of the cornea and the formation of fibrous tissues.

What are the possible complications after cataract treatment?

In the first days after discission, the patient may experience increased pressure in the eye. This symptom disappears without treatment. If this does not happen, you need to undergo an examination, as there is a risk of glaucoma. There may be other unpleasant consequences after the treatment of secondary cataracts:

IOL damage. If the lens is too tight against the capsule wall, the surgeon may inadvertently damage it when cleaning. The appearance of "flies" before the eyes, black dots indicates that the IOL has defects.
Retinal disinsertion. A complication develops rarely, but requires urgent treatment.
Cystic edema of the retina. This usually occurs in cases where the discission was carried out within six months after the replacement of the lens.
IOL displacement. Trauma can lead to it. Also, the probability of lens displacement is quite high during mechanical capsulotomy.
Infectious diseases of the eye. The infection can get during the operation or during the rehabilitation period if the patient does not observe hygiene and does not use the drops prescribed by the doctor.

Intraocular hemorrhages. If they do occur, they are minor, due to the fact that damage to the eye during laser capsulotomy is minimal.
Astigmatism. Violation of the integrity of the cornea can cause its curvature, resulting in the development of this refractive error. As a rule, it is possible to eliminate it immediately by applying additional sutures.
Sunglasses, give up alcohol, do not wear makeup, visit a doctor the next day after the procedure, as well as a week later and then once a month for six months.

In general, with timely diagnosis and treatment, the prognosis is almost always favorable. Specific measures for the prevention of secondary cataracts have not been developed. A person should lead a healthy lifestyle and do everything to strengthen their immune system.

Cataract surgery is a simple, fast and safe way to get rid of the problem. The procedure is performed on an outpatient basis under local anesthesia. But despite the simplicity and high efficiency, surgery can cause complications.

Recurrent cataract after lens replacement is a serious ophthalmic problem. The specific causes of surgical complications are not fully understood. The essence of the pathology is the growth of epithelial tissue on the lens. This leads to clouding of the lens and blurred vision.

According to statistics, in twenty percent of cases, a second cataract develops after surgery. Treatment of secondary cataract after lens replacement includes laser correction or surgery. So why is there a complication?

The reasons

Despite the fact that the true causes are still being studied by specialists, the provocative causes of this complication have been established:

burdened heredity;
age-related changes;
mechanical damage;
inflammatory processes;
ultraviolet radiation;
metabolic disorder;
eye diseases - myopia, glaucoma;
metabolic disorder;
radiation;
metabolic disease;
taking drugs with steroids;
bad habits (smoking, alcoholism);
intoxication.

Experts note the role of a poorly performed operation and medical error in the occurrence of complications. It is possible that the whole problem lies in the reaction of the cells of the lens capsule to the artificial material.

Symptoms

Surgical complication is a rather lengthy process. The first signs of a secondary cataract appear months or even years later. If after the operation your eyesight deteriorated and color sensitivity decreased, contact a specialist immediately. Most often, the complication occurs in young children and the elderly.

Replacing the lens can cause visual impairment again after a while.

As the secondary cataract progresses, the following symptoms appear:

spots before the eyes;
diplopia - doubling;
vagueness of the boundaries of objects;
grayish spot on the pupil;
yellowness of objects;
a feeling of "fog" or "haze";
image distortion;
lenses and glasses do not correct visual dysfunction;
unilateral or bilateral lesion.

In the early stages, visual function may not suffer. The initial stage can last up to ten years. The clinical picture largely depends on which part of the lens has clouded. Opacification in the peripheral part practically does not affect the quality of vision. If the cataract approaches the center of the lens, then vision begins to deteriorate.

Complication develops in the form of two forms:

Fibrosis of the posterior capsule. Compaction and clouding of the posterior capsule causes a decrease in vision.
Pearly dystrophy. The epithelial cells of the lens grow slowly. As a result, visual acuity is significantly reduced.

In the membranous form, a certain area of the lens tissue is absorbed, and the capsules grow together. A membranous cataract is dissected with a laser beam or a special knife. An artificial lens is placed in the resulting hole.

Opacities of the capsule are primary and secondary. In the first case, the complication occurs immediately after the operation or after a short time. Turbidity has a different shape and size. As a rule, this kind of clouding does not affect the quality of vision, therefore, it does not require mandatory treatment. Secondary opacities often occur due to cellular reactions and can worsen the results of the operation.

One of the signs of a secondary cataract is the appearance of glare before the eyes.

Effects

Removal of a secondary cataract can lead to such complications:

lens damage;
retinal edema;
·retinal disinsertion;
displacement of the lens;
glaucoma.

Diagnostic examination

Before correction, the specialist conducts an extended ophthalmological examination:

checking visual acuity;
using a slit lamp, a specialist determines the type of turbidity, and also eliminates swelling and inflammation;
measurement of intraocular pressure;
examination of the fundus vessels and the exclusion of retinal detachment;
if necessary, angiography or tomography is performed.

Before treatment, a comprehensive examination of the organs of vision is carried out, after which the doctor will tell you what to do next.

Methods of treatment

Currently, there are two main methods of dealing with clouding of the lens:

Surgical. The cloudy film is cut with a special knife.
Laser. This is a simple and safe way to get rid of the problem. Does not require any additional examinations.

In order to prevent patients, anticatarrhal eye drops are prescribed. The dosage is selected strictly by the doctor. In the next four to six weeks after the operation, drops are used that have an anti-inflammatory effect and prevent the development of an infectious process. The only contraindication to the use of surgical intervention is the refusal of the patient himself.

In the postoperative period, patients should avoid sudden movements, heavy lifting. Do not press on the eye and rub it. During the first months, it is not recommended to visit the pool, bath, sauna and play sports. Also, in the first four weeks, it is undesirable to use decorative cosmetics.

The first thing to do if symptoms of a secondary cataract occur is to make an appointment with an ophthalmologist

Laser dissection of secondary cataract

Laser therapy was developed by an ophthalmologist who studied physics and the possibility of using a laser in medical practice for a long time. Indications for laser treatment are:

clouding of the lens with a significant deterioration in vision;
reduced quality of life;
traumatic cataract;
glaucoma;
iris cyst;
blurred vision in bright light and in poor light conditions.

Unlike invasive surgery, laser therapy is not associated with infection risks, nor does it cause corneal edema or herniation. During surgery, the artificial lens is often displaced, the laser method does not damage or displace the lens.

It is worth highlighting the advantages of the laser technique in the following:

ambulatory treatment;
fast process;
no need for extensive diagnostics;
minimal restrictions in the postoperative period;
does not affect performance.

Laser discission is a modern minimally invasive way to eliminate secondary cataracts.

Treatment of secondary cataract with a laser has a number of limitations, these include:

scars on the cornea, edema. Because of this, it will be difficult for the doctor to examine the structures of the eye during surgery;
macular edema of the retina;
inflammation of the iris;
uncompensated glaucoma;
clouding of the cornea;
with great care, the operation is performed with rupture and detachment of the retina.

There are also relative contraindications:

earlier than six months after cataract surgery for pseudophakia;
earlier than three months after cataract surgery for aphakia.

Laser discission is performed under local anesthesia. Before the procedure, the patient is instilled with drops that dilate the pupils. As a result, it will be easier for the surgeon to see the posterior lens capsule.

Within a few hours, the patient will be able to return home. There is no need for sutures or bandages. To avoid the development of inflammatory reactions, doctors prescribe eye drops with steroids. A week and a month after laser discission, you should see an ophthalmologist to evaluate the results.

Sometimes after the operation, patients may present complaints similar to those that were before the operation. So, vision may deteriorate, fog and glare appear before the eyes.

Summary

Secondary cataract after lens replacement is a serious complication requiring surgical intervention. A sign of pathology is visual impairment, blurry objects, image distortion. Patients complain of the appearance of glare before the eyes. If these symptoms appear, you should immediately consult a specialist. Elimination of secondary cataract in our time is carried out with the help of laser discission. This is a simple, safe, and most importantly, effective solution to the problem.

The reasons

Despite the fact that the true causes are still being studied by specialists, the provocative causes of this complication have been established:

burdened heredity;
age-related changes;
mechanical damage;
inflammatory processes;
ultraviolet radiation;
metabolic disorder;
eye diseases - myopia, glaucoma;
metabolic disorder;
radiation;
metabolic disease;
taking drugs with steroids;
bad habits (smoking, alcoholism);
intoxication.

Symptoms

Replacing the lens can cause visual impairment again after a while.

As the secondary cataract progresses, the following symptoms appear:

spots before the eyes;
diplopia - doubling;
vagueness of the boundaries of objects;
grayish spot on the pupil;
yellowness of objects;
a feeling of "fog" or "haze";
image distortion;
lenses and glasses do not correct visual dysfunction;
unilateral or bilateral lesion.

Complication develops in the form of two forms:

Fibrosis of the posterior capsule. Compaction and clouding of the posterior capsule causes a decrease in vision.
Pearly dystrophy. The epithelial cells of the lens grow slowly. As a result, visual acuity is significantly reduced.

One of the signs of a secondary cataract is the appearance of glare before the eyes.

Effects

Removal of a secondary cataract can lead to such complications:

lens damage;
retinal edema;
·retinal disinsertion;
displacement of the lens;
glaucoma.

Diagnostic examination

Before correction, the specialist conducts an extended ophthalmological examination:

checking visual acuity;
using a slit lamp, a specialist determines the type of turbidity, and also eliminates swelling and inflammation;
measurement of intraocular pressure;
examination of the fundus vessels and the exclusion of retinal detachment;
if necessary, angiography or tomography is performed.

Before treatment, a comprehensive examination of the organs of vision is carried out, after which the doctor will tell you what to do next.

Methods of treatment

Currently, there are two main methods of dealing with clouding of the lens:

Surgical. The cloudy film is cut with a special knife.
Laser. This is a simple and safe way to get rid of the problem. Does not require any additional examinations.

The first thing to do if symptoms of a secondary cataract occur is to make an appointment with an ophthalmologist

Laser dissection of secondary cataract

Laser therapy was developed by an ophthalmologist who studied physics and the possibility of using a laser in medical practice for a long time. Indications for laser treatment are:

clouding of the lens with a significant deterioration in vision;
reduced quality of life;
traumatic cataract;
glaucoma;
iris cyst;
blurred vision in bright light and in poor light conditions.

It is worth highlighting the advantages of the laser technique in the following:

ambulatory treatment;
fast process;
no need for extensive diagnostics;
minimal restrictions in the postoperative period;
does not affect performance.

Laser discission is a modern minimally invasive way to eliminate secondary cataracts.

Treatment of secondary cataract with a laser has a number of limitations, these include:

scars on the cornea, edema. Because of this, it will be difficult for the doctor to examine the structures of the eye during surgery;
macular edema of the retina;
inflammation of the iris;
uncompensated glaucoma;
clouding of the cornea;
with great care, the operation is performed with rupture and detachment of the retina.

There are also relative contraindications:

earlier than six months after cataract surgery for pseudophakia;
earlier than three months after cataract surgery for aphakia.

Sometimes after the operation, patients may present complaints similar to those that were before the operation. So, vision may deteriorate, fog and glare appear before the eyes.

Summary

Approximately 20-35% of patients undergoing lens replacement surgery may experience a secondary cataract 6-18 months after the operation. It also requires treatment and medical attention.

This complication is more common in younger patients. Secondary cataracts often develop in children who have undergone surgery to remove congenital cataracts. Elderly patients after surgery may experience fibrosis of the posterior lens capsule, but it is the secondary cataract that is observed mainly in younger patients. What is she like?

A cataract is a lesion that occurs in the optical system of the eye, in which the lens becomes cloudy. During the operation, the lens is removed and replaced with an artificial one. The lens itself in the eye is located in a special capsular bag, the front wall of which is cut during surgery to remove the clouded lens. The back wall is not affected, as it provides stabilization of the position of the artificial lens in the eye in the first months after the operation. Secondary cataract is a change that occurs from the side of the posterior capsule, including its clouding and fibrosis.

This lesion can occur in three forms:

Fibrous - connective tissue elements grow;
Proliferative - the appearance of specific cells, which are an indicator of the duration of the process;
The thickening of the capsule is the only form that does not cause discomfort.

Certain causes of the appearance of a secondary cataract cannot be established. There is no specialist who can guarantee the appearance of symptoms of lens changes after surgery or during the recovery period.

One of the first symptoms that indicates the possible appearance of a recurrent cataract may be blurred vision after surgery. The development and appearance of this disease can occur in different ways. So, for some it occurs quite quickly, while for others it can develop over several years. In most cases, the first symptoms appear at least three months after surgery.

How is it diagnosed?

Secondary cataract requires a visit to an ophthalmologist who will conduct examinations. First of all, visual acuity is measured and the boundaries and areas in which the visual fields fall out are determined.

Next, biomicroscopy is performed - a procedure for examining with a slit lamp. During it, the structure of the eye is determined, it is possible to detect the location of the pathological focus, as well as determine its size and parameters. Additionally, the doctor may prescribe optical coherence tomography if edema is suspected.

Secondary cataracts can develop due to diseases of the internal organs that a person has. First of all, it is required to cure them, or to achieve the value of indicators close to the norm.

How is it treated?

Secondary cataract requires mandatory treatment, otherwise, complete or partial blindness may develop. The best treatment option is laser discission. It is widely used in ophthalmology, is carried out quickly and does not require hospitalization.

This procedure is carried out as follows:

To begin with, mydriatic is dripped into the eye in order to expand the pupil;
Next, a small hole is created with a laser;
Then, photodestruction (destruction) of the altered tissues is performed.

Laser removal of a repeated cataract is less traumatic, as it does not require the introduction of instruments into the eye. Almost 100% of patients notice a significant improvement in vision after the procedure. However, this method has some contraindications, including the presence of scars, corneal edema, fundus pathology, and inflammatory processes.

If the patient has symptoms for which the laser is contraindicated, surgical intervention is used. This procedure is called capsulotomy and is performed quite rarely, since after it there is a high risk of infections, complications, and, in addition, a long recovery period is required.

In this regard, laser capsulotomy is the most successful option. For its implementation, a special YAG laser on an yttrium aluminum garnet is used. The use of such a laser minimizes the risk of complications. Most patients experience improvement in vision already at the beginning of the recovery period. Bright flashes and floating spots appearing before the eyes may be disturbing, but after the restoration of the operated eye, they will disappear.

Recovery period

In order for the rehabilitation to take place as quickly as possible, and the effect is preserved for a long time, it is necessary to follow some recommendations:

Use sunglasses;
Do not do eye makeup for 2-3 weeks;
Bury eyes with drops prescribed by a doctor.