Secondary cataract after lens replacement: treatment and reviews

Capsule of the lens is inherent elasticity. During the operation to remove cataracts in the eye, an artificial lens is placed, replacing the present one. In this case, the posterior capsule serves as a support for a new intraocular lens. It happens that the capsule begins to grow dull, which causes such a phenomenon as secondary cataract after lens replacement. Treatment, reviews about which the most positive, is conducted in accordance with medical indications. The newest methods and high-quality equipment are applied.

Causes of the phenomenon

Where does secondary cataract appear after lens replacement? The doctors' comments on this complication testify that the exact reasons for its occurrence are not disclosed.

The development of a secondary complication is explained by the proliferation of epithelium localized on the surface of the posterior capsule. There is a violation of its transparency, which causes a decrease in vision. Such a process can not be related to the surgeon's mistake during the operation. Secondary cataract after the replacement of the lens, the causes of which lie in the reaction of the organism at the cellular level, is a fairly common occurrence. The cells of the lens epithelium are transformed into fibers that are functionally inferior, have an irregular shape and are opaque. When they move to the central part of the optical zone, turbidity develops. Visual impairment may be caused by fibrosis of the capsule.

Risk factors

Ophthalmologists have established a number of factors explaining why there is a secondary cataract after lens replacement. These can be classified as follows:

• Age of the patient. In childhood, cataracts after surgery appear more often. This is due to the fact that tissues in the young body have a high level of ability to regenerate, which causes the migration of epithelial cells and their division in the posterior capsule.
• IOL form. The intraocular lens of the square shape allows the patient to significantly reduce the risk of injury.
• IOL material. Doctors have found that after the introduction of the IOL based on acrylic, secondary clouding of the lens occurs less frequently. Silicone constructions provoke the development of complications more often.
• The presence of diabetes, as well as some common or ophthalmic diseases.

Preventive measures

To prevent the emergence of secondary cataracts, doctors apply special methods:

• Pollinate capsules of the lens to maximize the removal of cells.
• They make a choice of specially designed structures.
• Apply medication for cataracts. They are buried in the eyes strictly according to their intended purpose.

Signs of the appearance of secondary cataracts

In the early stages of secondary cataract after the replacement of the lens in general may not manifest itself. The duration of the initial stage of the disease can range from 2 to 10 years. Then obvious symptoms begin to appear, and also loss of objective vision occurs. Depending on the area in which the lens has deformed, the clinical picture of the disease can vary significantly.

If the secondary complication has manifested itself on the periphery of the lens, then it may not cause impairment of vision. As a rule, the pathology is found on a routine examination with an ophthalmologist.

How does the pathological process manifest itself, such as secondary cataract after lens replacement? Treatment (symptoms and appropriate examinations must confirm the diagnosis) is prescribed with a persistent drop in visual acuity, even if it was completely restored during surgery. Other manifestations include the presence of a shroud, the emergence of light from sunlight or artificial light sources.

In addition to the above symptoms, monocular bifurcation of objects may occur. The closer the cloud to the center of the lens, the worse the patient's vision . Secondary cataracts can develop on one eye as well as on both. There is a distortion of color perception, myopia develops. External signs are usually not observed.

Treatment

Secondary cataract after lens replacement, the treatment of which is successfully carried out in modern ophthalmological clinics, is removed by capsulotomy. This manipulation helps to free the central zone of optics from opacity, allows light rays to enter the eye, significantly improves the quality of vision.

Capsulotomy is performed both mechanically (using instruments) and laser method. The latter method has great advantages, since it does not require the introduction of a surgical instrument into the cavity of the eye.

Surgical intervention

How does secondary lens cataracts be eliminated? Treatment involves surgery. Such surgical intervention presupposes dissection or dissection of the turbid film with the help of a surgical knife. Manipulation is indicated in the case when secondary cataract after lens change caused major complications, and there is a possibility that the patient will go blind.

In the course of the operation, cruciform incisions are performed. The first is done in the projection of the visual axis. As a rule, the hole has a diameter of 3 mm. It can have a greater indicator if you need to examine the bottom of the eye or require photocoagulation.

Surgical interventions

The surgical method is applied to both adult patients and children. However, a fairly simple operation has a number of significant drawbacks, which include:

• Penetration of the eye infection;
• Getting injured;
• Corneal edema;
• The formation of a hernia as a consequence of a violation of the integrity of the membrane.

Features of laser treatment

What innovative methods are used to eliminate such a problem as secondary lens cataracts? Treatment is performed using laser beams. This method is highly reliable. It assumes the presence of precise focusing and the cost of a small amount of energy. Typically, the energy of the laser beam is 1 mJ / pulse, but the value can be increased if necessary.

Interference with a laser was called discitation. It has a high level of efficiency. With this treatment, a hole is made in the back wall of the capsule by burning. Through it, a clouded capsule is removed. For this method, we use a YAG laser. In modern medicine, this method is preferred.

The patients' testimonies testify that such intervention does not require a stay in the hospital, the operation is very fast and does not cause pain or discomfort. Manipulation is performed using local anesthesia.

How is secondary cataract removed after lens replacement? Treatment of complications with laser involves the following stages:

• Dilation of the pupil through medication. Eye drops are applied to the cornea, which promote the dilatation of the pupils. For example, tropicamide 1.0%, phenylephrine 2.5%, or cyclopentolate 1-2% is used.
• To prevent a sharp increase in pressure inside the eye, apraklonidine 0.5% is used after the operation.
• The implementation of several laser shots using a special device mounted on a slit lamp causes the appearance of a transparent window in the cloudy capsule.

How does a person feel after removing through the laser such a phenomenon as secondary cataract after lens replacement? The patients' testimonies indicate that after the operation they went home within a few hours. Seams and dressings with such interference is not required. Patients are prescribed hormonal eye drops. Their use in the postoperative period will be the last step on the way to restoring vision.

A week later, the patient undergoing the surgery will have a scheduled examination of the ophthalmologist to make sure that everything goes right.

One more examination is shown a month later. It is not considered to be planned, but it is desirable to pass it. So you can identify possible complications and remove them in a timely manner. It should be noted that the vast majority of complications occur within a week. Later they arise extremely rarely.

For the most part, secondary cataracts are eliminated through a single operation by means of a laser. Secondary intervention is extremely rare. The likelihood of complications from this kind of treatment is very small and is about 2%.

In what cases is a dyssia appointed?

The discontinuation of secondary cataracts is applied if:

• A damaged rear capsule stack causes a sharp drop in vision;
• Poor vision interferes with the patient's social adaptation;
• There are problems with seeing objects with excessive or poor illumination.

Strict contraindications

Is it always possible to remedy such complications as secondary cataract after lens replacement? There are indisputable contraindications. Moreover, they can be absolute, excluding the possibility of any manipulation. These include:

• The presence of swelling or scar tissue in the area of the cornea, which prevents the ophthalmologist from clearly discerning intraocular structures during surgery;
• The occurrence of an inflammatory process in the iris of the eye;
• Presence of macular edema of the retina;
• Opacity in the cornea;
• The thickness of the pupil membrane is 1.0 mm.

Relative contraindications

Among the relative contraindications include those in which the risk of secondary complications is increased:

• The term of surgical intervention for cataract removal for artifacts is less than six months, and for aphakia less than 3 months;
• Full contact of the posterior capsule with the IOL;
• Pronounced neovascularization of the pupil membrane;
• Presence of uncompensated glaucoma;
• Presence of inflammatory processes in the anterior segment of the eye.

The operation is performed with great care, if the patient has previously observed retinal detachment or a rupture.

The laser method of treatment has its disadvantage. Laser radiation can damage the optical part of the artificial lens.

Complications

What is the effect of the laser method in the treatment of such a disease as secondary cataract after lens replacement? The consequences may be undesirable.

• After replacing the lens with a secondary cataract, black flies can appear, which is caused by damage to the structure of the lens during surgery. On sight this defect has no influence. Damage of this kind is caused by poor focusing of the laser beam.
• A dangerous complication is retina swelling of the retina. In order not to provoke its appearance, surgical intervention should be carried out only six months after the previous operation.
• Regmatogenic retinal detachment . This phenomenon is extremely rare and is caused by myopia.
• Increased IOP level. Usually this is a rapidly occurring phenomenon and does not pose any threat to health. If it lasts a long time, this indicates that the patient has glaucoma.
• Sublingu- lation or dislocation of the IOL is observed in rare cases. Such a process, as a rule, causes an IOL with a silicone or hydrogel base with a haptic in the form of discs.
• The chronic form of endophthalmitis is also infrequent. It is caused by the release of isolated bacteria into the vitreous region.
• Fibrosis (subcapsular clouding) is rare. Sometimes such a process develops within a month after the intervention. An early form of complication can trigger a shortening of the anterior capsule and the formation of capsulofimosis. Development is influenced by the model and material from which the IOL was made. Often this deviation is caused by silicone models with a haptic in the form of discs and less often IOLs, which consist of three parts. The basis of their optics is acrylic, and the haptics are made from PMMA.

To prevent complications after surgery, doctors advise regularly to use eye drops that prevent the development of cataracts.

Conclusion

From all of the above, it can be concluded that after the operation to remove cataracts, there is often a complication such as a secondary lens cataract. Treatment of the disease with the use of modern methods gives good results, but there are also possible side reactions.