Posterior Capsule Opacification, also called After Cataract is the most common long-term complication of Extra Capsular Cataract Extraction.
Posterior capsular opacification can occur months or years after cataract surgery, unlike most other cataract surgery complications that tend to occur during or soon after the procedure. Within 2 to 5 years after surgery, PCO causes decreased visual acuity in 20 percent to 40 percent of eyes that have had cataract surgery.
Risk Factors: The problem is age-dependent and occurs more frequently in young patients. The rate of PCO among children who have surgery to remove congenital cataracts ranges from 20%-50% by 2-4 years. The problem occurs more frequently in patients with PMMA lens and hydrophilic acrylic lenses.
Pathogenesis: Opacification of the posterior capsule appears to be influenced by lens epithelial cells that are left behind in the eye during cataract removal. These cells multiply, migrate across the posterior lens capsule and undergo changes that cause fibrous or pearl-type opacities in the capsule. The exact mechanism is not completely understood, but it appears to be a aberrant would healing response to cataract surgery.
Treatment: Currently, the only treatment of PCO is a type of laser surgery called Nd:YAG laser capsulotomy. In this procedure, a laser is used to create a central opening in the cloudy posterior capsule to restore sight. The procedure is quick and easy, but possible complications of laser capsulotomy include retinal detachment, damage to the intraocular lens (IOL), increase in intraocular pressure and other problems.
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