Can Cataracts Come Back After Surgery?

Cataracts, or an opacification or clouding of the eye’s lens, affect millions of people – it’s one of the most common eye conditions in the world. Cataracts often affect older people, although it’s possible for them to develop in younger patients as well. Today, laser surgery is commonly used to remove cataracts, and it has a high success rate. Traditional cataract surgery using blades is also still commonly used to great effect.

Have you ever wondered whether cataracts can come back after surgery?

The answer isn’t quite as simple as a “yes” or “no.” Cataracts cannot grow back once they’ve been removed. But it is possible for a secondary (or new) cataract to form. So, yes, cataracts can come back after cataract surgery; it’s not the old one growing back, but a new one forming. The medical term for this is posterior capsular opacification, or PCO.

Let’s take a closer look at how cataracts surgery works and how secondary cataracts or PCO happens. Then, we’ll discuss the symptoms of this condition and what can be done about it to help patients see clearly once again.

How Does Cataract Surgery Work?

There are two types of cataract surgery: traditional cataract surgery, which has been used for many years, and the newer laser-assisted cataract surgery.

Traditional Cataract Surgery

This type of cataract surgery involves using a tiny blade to make an incision on the side of the eye’s lens (the cornea) and removing the clouded lens. After that, an artificial lens called an intraocular lens is inserted in place of the natural lens. In some cases, sutures might be needed to close the incision, but more often than not the incision is left alone to heal over time. Most patients are fully healed within a few days or weeks of cataract surgery.

Laser Cataract Surgery

Laser-assisted cataract surgery uses laser technology and 3D imaging to make the incision. An advanced laser called a femtosecond laser creates an opening in the cornea’s front layer, and then the laser breaks

up the clouded lens before it’s sucked out through the incision. Then, an intraocular lens replaces the natural lens in the same manner as traditional cataract surgery.

Both types of cataract surgery are fast, efficient, and very safe. They’re both widely used today, including by top cataract surgeons in Buffalo. In fact, cataract surgery is one of the most common types of surgery performed in the world, with a very high success rate.

Can You Have Cataracts Twice?

As mentioned above, yes, you can have cataracts twice, even after surgery. Secondary cataracts, sometimes called after-cataracts, isn’t particularly common but it is possible.

Secondary cataracts doesn’t develop immediately after your cataract surgery. It will typically take months or, even more commonly, years before developing. And here’s the good news: it’s less common than ever before. For many years, nearly half of all patients who had cataract surgery developed secondary cataracts at some point. Now, thanks to technological improvements particularly in laser surgery, only about four to 12 percent of patients experience secondary cataracts.

PCO is still the most common complication after cataract surgery, but it occurs less frequently than ever before. And research is ongoing into ways to make it even less common.

What is a Secondary Cataract?

Secondary cataracts or posterior capsular opacification (PCO) occurs when the membrane around the lens capsule (not removed during surgery) becomes cloudy and starts to impair vision. New protein cells begin to grow on the back of the lens capsule, which obscures vision just like a cataract does.

There are actually two types of secondary cataracts:

· Pearl PCO: Responsible for the majority of secondary cataracts cases, pearl PCO involves normal differentiation of lens epithelial cells (LECs) in the equatorial lens region.

· Fibrous PCO: Fibrous PCO involves abnormal growth of LECs in the lens.

To put it simply, secondary cataracts is the opacification of the membrane around the lens capsule, which wasn’t removed during cataract surgery. It usually starts to opacify months or years after cataract surgery.

What Makes Secondary Cataracts More Likely?

The development of secondary cataracts is, on the whole, not extremely common. But there are a few conditions and factors that make this condition more likely to occur. One is age; it turns out that younger cataracts patients are more likely to develop secondary cataracts. Other factors include:

· Diabetes – Diabetes and vision problems are closely linked. Patients who have diabetes or had it in the past have a higher incidence of PCO development.

· Uveitis – Uveitis occurs when the uvea, the middle part of the eye, becomes inflamed. This results in itching and redness. Patients with this condition are more likely to develop secondary cataracts.

· Myotonic dystrophy – Related to muscular dystrophy, myotonic dystrophy is an inherited disease that involves prolonged muscle contractions and difficulty relaxing certain muscle groups. Cataracts often develop as a symptom of this condition, and people with myotonic dystrophy often require multiple capsulectomies to restore proper vision.

· Retinitis pigmentosa – People with retinitis pigmentosa have a higher occurrence rate of secondary cataracts. This condition involves the breakdown of cells in the retina, which causes symptoms like loss of peripheral vision and difficulty seeing at night.

· Cataracts caused by trauma – It’s possible for cataracts to be caused by injury or trauma to the head or eye. When this is the case, the chance of secondary cataracts occurring is much higher.

Secondary Cataract Symptoms

What are the main secondary cataract symptoms? How can you tell if you’re developing this condition?

Blurry Vision

Blurry vision after cataract surgery is the most common sign of secondary cataracts. As mentioned, the blurred vision won’t occur immediately after surgery. It will probably happen months or even years afterward.


Patients might notice an increased glare from light sources, such as the sun or car headlights when driving at night. It’s also relatively common for those with secondary cataracts to see halos around these light sources.

Lack of Visual Acuity

A reduction in visual acuity is another common sign of secondary cataracts. This might manifest in difficulty reading text or seeing the television, difficulty driving and seeing road signs, etc. Patients might also notice a reduction in the accurate perception of colors.

Can Secondary Cataracts Be Prevented?

It is not possible to prevent the occurrence of secondary cataracts in every case. However, there are things that can be done to make it less likely. Advances in surgical techniques are one approach; as the technology improves and processes are further refined, ophthalmologists hope to reduce the risk of secondary cataracts developing. Extensive polishing of the epithelial cells during cataract surgery can also help.

New intraocular lens designs (the artificial lenses that replace the clouded cataract lens) show promise for reducing cataract surgery side effects, including secondary cataracts. Square-edged intraocular lenses can reduce the risk of PCO development, and there is also evidence that changes to the surface chemistry of the lens makes PCO development less likely.

Last but not least, drugs that suppress certain cell growth could be used to inhibit the growth of lens cells that end up obscuring vision. The Food and Drug Administration has not approved prescription drugs for this reason yet, so it remains to be seen if medication could play a role in preventing the development of secondary cataracts.

Secondary Cataract Treatment

Secondary cataracts can certainly be a frustrating thing to deal with. After all, cataract surgery was supposed to solve the issue. It’s understandable that patients are frustrated when their vision becomes blurry once again. Luckily, treating secondary cataracts is generally very simple and easy.

Secondary cataract surgery is performed via a procedure called YAG laser capsulotomy, and it’s widely effective in treating secondary cataracts and helping patients to experience restored vision after the development of secondary cataracts.

YAG Laser Capsulotomy

YAG laser capsulotomy is a quick, painless procedure. First, the eye is numbed with special drops. Then, a laser creates a small opening in the clouded part of the lens capsule. This allows light to shine through to the retina, allowing the lost vision to be restored. Most often, the patient can return home immediately with an eyedrop treatment, and will probably be able to return to normal activities – driving, working, etc. – within a day or two.

YAG laser capsulotomy only takes about five minutes, even less than the already quick cataract surgery itself. You’ll probably need to revisit the eye doctor’s office in a week or so for a follow-up appointment to make sure things are progressing well and you’re not experiencing any side effects.

Contact the Ophthalmologists at ECVA if You’re Experiencing Secondary Cataract Symptoms

Are you experiencing blurred vision or other symptoms of secondary cataracts? It’s time to make an appointment with Eye Care & Vision Associates to see the top ophthalmologists in Buffalo, NY. We can help you understand cataract symptoms including secondary cataracts and map out a treatment plan to restore your vision. Contact ECVA, your eye doctor in Buffalo, NY, to get started. We’re here to help! Schedule an appointment at your closest ECVA clinic today.

Why Is My Vision Getting Worse?

Many people know that vision changes can occur at any time. However, if your vision is declining year after year or suddenly takes a turn for the worst, you may wonder why it’s happening.  

Here is a look at common reasons for declining vision, as well as the symptoms you may experience.  


As people age, their visual acuity typically decreases, especially when it comes to near-vision. Often, this process is unavoidable. Additionally, it’s normal for vision to decline further as time passes.  

Often, age-related vision changes begin around middle age, commonly among adults over 40. During that time, presbyopia – a loss of lens flexibility – can alter visual acuity, particularly when viewing nearby objects. However, some may not see shifts until they’re far beyond 40, while others may see these changes begin earlier.  

Usually, the most common symptoms of age-related changes are trouble reading small print, fatigue after reading, holding items farther away to read, needing brighter light, and squinting.  


An eye injury can lead to a range of physical changes that may impact your vision. If the optic nerve is damaged, it can cause significant vision loss. Similarly, an injury-related retinal detachment may cause a rise in the number of floaters, bright light flashes, and blurriness.  

Eye injuries can also cause other kinds of damage, many of which require quick treatment to prevent or reduce vision loss. Since that’s the case, fast action is always recommended, including seeing your eye health provider for an immediate assessment.  

UV Damage  

UV light harms the eyes, potentially leading to vision changes. Often, the damage begins during childhood, a period when most people aren’t as cautious when it comes to eye health. However, it may not be apparent until adulthood. Additionally, choices as an adult also influence the equation.  

In most cases, UV damage leads to blurriness. Eye pain, redness, and light sensitivity are also symptoms you may experience.  

Eye Strain  

Due to the rise of digital devices, eye strain is surprisingly common, and it can lead to certain vision changes. When people view screens, they tend to blink less. Additionally, they’re keeping their focus on a specific distance.  

In most cases, tiredness or fatigue is the most apparent symptom, coupled with dry, itchy, or burning eyes. However, you may experience headaches, light sensitivity, and soreness, too.  


Technically, cataracts are another age-related reason for vision decline. As proteins in the lens break down, they can cloud the lens, leading to blurry vision.  

Along with being very common, cataracts are typically incredibly treatable, particularly when caught early. Some signs of cataracts include blurriness, glare, halos, and faded or yellowed colors.  


Glaucoma is a condition involving elevated pressure in the eye, leading to damage to the optic nerve. As the damage occurs, peripheral vision typically declines first. Blurriness and halos may also develop, as well as trouble seeing in low-light conditions.  

In some cases, glaucoma is also accompanied by pain. However, that isn’t always the case.  

Since vision changes are potentially caused by a range of conditions, including some severe problems that can lead to permanent vision loss, it’s best to see your eye health provider whenever you notice a shift. Additionally, attending your annual appointments ensures your provider can monitor your eye health and take quick action should they spot an issue that’s yet to result in symptoms.  

At ECVA, the safety and health of our patient’s eyes are our priority. If you are experiencing vision changes or simply haven’t seen your eye care provider in the past year, the ECVA team is here to help. Schedule an appointment at your closest ECVA clinic today.  

What Are the Early Signs of Glaucoma?

Glaucoma is an eye condition impacting the optic nerve. As intraocular pressure builds, damage to the optic nerve can occur, leading to permanent vision defects and loss, potentially leading to blindness.  

While glaucoma isn’t typically preventable, early detection is crucial if you want to avoid optic nerve damage and slow the progression of vision loss. By knowing the early signs of glaucoma, you can take action at a critical time, increasing your odds of maintaining as much of your vision as possible.  

Here’s what you need to know about the early signs of glaucoma, as well as when you should see an eye health provider.  

Early Signs of Glaucoma  

Generally, there are a few symptoms that can be early signs of glaucoma. One of the most common ones is the loss of peripheral – or side – vision. Over time, it can lead to a sort of tunnel vision, though the process is often slow and hard to identify right when it begins.  

Halos around light are another symptom of glaucoma. Sensitivity to light is similarly a classic sign. In both of these cases, the issues may be particularly apparent in specific situations, such as driving at night.  

Other forms of vision loss – including a sudden decline in acuity or the visual field – can indicate glaucoma, too. Eye redness and pain could be a symptom of acute glaucoma. Haziness of the cornea is a potential symptom, though it’s usually only present with childhood glaucoma.  

In some cases, unexplained nausea or vomiting may also be related to glaucoma, particularly the acute form. The same goes for headaches and blurry vision.  

When to See an Eye Health Provider  

Ultimately, it’s always wise to see an eye health provider whenever you notice any shifts in the visual field or acuity, as well as symptoms of physical changes in the eye. Glaucoma typically isn’t preventable. However, with proper management, vision loss can be minimized.  

Additionally, some of the early signs of glaucoma are also symptoms of other serious eye conditions. For example, redness and eye pain may indicate an infection and, depending on the type, permanent eye damage can occur with surprising speed. Halos may be a sign of glaucoma, cataracts, retinal detachment, and many other potentially serious conditions, all of which should be assessed quickly to determine if treatment is necessary.  

However, even if you don’t have any of the early signs of glaucoma or symptoms of an eye condition, it’s still wise to see your eye health provider regularly. For most adults, an annual appointment is enough to monitor for vision changes and signs of eye health issues, though some may require more frequent visits if certain risks factors are present or they have an eye condition that requires ongoing treatment and tracking.  

At ECVA, the safety and health of our patient’s eyes are our priority. If you have early signs of glaucoma or haven’t seen your eye care provider in the past year, the ECVA team is here to help. Schedule an appointment at your closest ECVA clinic today.