Posterior subcapsular opacification is another term for posterior capsular opacification (PCO), a common complication following cataract surgery that can cause blurry vision.

PCO develops in people who undergo cataract surgery, and is also sometimes nicknamed a “secondary cataract.” It’s estimated that between 20% and 50% of adults go on to develop PCO within 2 to 5 years of the initial surgery.

When you have PCO, you may have similar symptoms to the original cataract(s) you had before undergoing corrective surgery. Notably, you might experience increasingly blurry vision that disrupts your everyday life.

While it can be frustrating to experience new eye symptoms after you’ve gone through cataract surgery, developing a secondary cataract is a very common and treatable condition.

Common symptoms of PCO include:

  • blurry vision
  • sensitivity to light
  • seeing halos
  • glare
  • reading difficulties
  • overall decrease in vision

It’s possible to experience PCO symptoms that worsen gradually over weeks, months, or even up to several years.

If you’re experiencing any visual changes after having cataract surgery, this can be a sign of PCO development that requires confirmation from an eye doctor.

When you have cataracts, your condition may progress to a point where you need cataract surgery.

During this procedure, a surgeon removes the affected lens of the eye(s). A new and artificial intraocular lens (IOL) is then set in place of the eye lens within the lens capsule. While the lens is replaced, the capsule holding it is left alone.

While cataract removal and the installation of an IOL can help you see again, it’s also possible for residual epithelial cells to increase and migrate over the lens capsule. This can then lead to cloudy vision over time.

Residual epithelial cells are a few cells left from the outside of the lens. Though most are removed, it’s impossible to remove every last one.

Due to its subsequent formation after cataract surgery, PCO is also occasionally referred to as scar tissue on the eye. It is not, however, a return of cataracts. The protein buildups on an eye’s lens that lead to cataract formation can only occur on your natural lens, and not an artificial IOL.

Not only is PCO common after cataract surgery, but it’s also considered the most common complication related to this procedure.

Pediatric cases of PCO are also much more common than those in adults. In fact, the incidence rate is as high as 100%. Also, younger people with PCO tend to have more severe symptoms.

Other possible risk factors for PCO development include:

Once you’ve undergone cataract surgery, you will likely see your ophthalmologist during regularly scheduled follow-up exams.

It’s possible for this eye specialist to see early signs of PCO during one of these visits due to the gradual progression of lens capsule cloudiness. However, you should also schedule an appointment right away if you start experiencing vision changes after cataract surgery.

PCO is diagnosed with similar tests as cataracts. During a comprehensive eye exam, your ophthalmologist may use a slit lamp to get a better look at the front part of your eye. This includes your newly-installed IOL and the lens capsule.

In addition to any cloudiness an ophthalmologist observes during a slit lamp examination, they will also conduct vision acuity tests to help confirm your symptoms.

Once a doctor diagnoses PCO, they will likely recommend treatment with a posterior capsulotomy. This is a laser-based procedure that helps to make an opening in the cloudy capsule around your eye’s IOL so light can pass through it unobstructed.

As with your initial cataract surgery, posterior capsulotomy is performed by an ophthalmologist. The entire procedure takes about 5 minutes to complete, and you should start seeing improvements in your vision within 24 hours.

There is currently no reliable method of PCO prevention after having cataract surgery.

However, researchers are actively looking into possible preventive methods in the future. These might include different IOL designs and materials, novel surgery techniques, as well as certain medications to help reduce the risk of lens epithelial cell migration.

While existing medications are also being studied to help reduce PCO risk, more human studies are needed to determine their efficacy, as well as any possible negative effects on surrounding tissues near the lens capsule.

Cataract surgery itself has a high success rate, but PCO remains a common complication. Despite its occurrence, PCO also has a good outlook. Some people may need an additional posterior capsulotomy, but this isn’t common.

PCO is treatable with laser surgery in the form of posterior capsulotomy. As with other eye surgeries, laser treatment for PCO does carry the risk of side effects and complications that you should discuss with your ophthalmologist. Among these risks are:

Unfortunately, PCO will not go away on its own or get better over time. Laser treatments are the most viable option for addressing IOL cloudiness, so you can see better.

PCO is a common condition that can form after cataract surgery. This affects the lens capsule in your eye that holds a surgically-placed IOL in place, and is not technically a new cataract. Nevertheless, PCO can cause similar symptoms you experienced with cataracts.

If you start to experience cloudy, hazy vision or difficulties with reading, you should contact an ophthalmologist right away. They can conduct tests to determine whether you have PCO, so they can then help you schedule a laser treatment to help resolve the issue.

The possible development of PCO can be disheartening if you’ve recently undergone cataract surgery. While researchers are looking at possible ways to prevent PCO in the future, laser-based posterior capsulotomy has a high success rate to help you see better.