Some people report persistent or newly developed cloudy vision after cataract surgery. This is typically due to posterior capsular opacification.

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Cataracts cause cloudy or blurry vision. They are an area of clouding on the lens of the eye. The only effective way to treat cataracts is with surgery.

Following recovery, a person will typically see clearly again. However, anywhere from a few weeks to a few years later, a person may develop posterior capsular opacification (PCO). Sometimes referred to as scarring or secondary cataract, PCO causes cloudy vision to return.

This article reviews what PCO is, how common it is, its causes, treatments, and more.

PCO is the most common complication associated with cataract surgery. About 20–50% of people who get cataract surgery will develop PCO within 2–5 years following the procedure.

Younger age is a risk factor for PCO. Nearly all children who undergo the procedure develop PCO.

PCO causes cloudy vision. It can also cause other symptoms, such as:

  • reduction in contrast sensitivity
  • lack of binocular vision
  • halo effect

The natural lens is covered by a transparent membrane called the lens capsule. After cataract surgery, the membrane that covered the backside of the lens is left behind, untouched. This posterior membrane holds the replacement artificial lens implant in place. PCO occurs when the posterior capsule becomes cloudy.

Newer cataract surgery techniques may be helping reduce the likelihood of PCO, but they have not stopped it from occurring entirely.

A surgeon replaces the natural lens with an artificial one during cataract surgery. The posterior capsule holds the new lens in place.

After cataract surgery, the transparent posterior capsule can become cloudy. This can create new symptoms that degrade the clear vision experienced after successful surgery.

The leading cause of PCO is the migration and proliferation of residual lens epithelial cells (LECs) following cataract surgery. The cells start forming fibrous connective tissue, which can cause cloudy or blurry vision.

Historically, surgeons inserted a sterile needle into the eye to painlessly create a central opening in the cloudy membrane. Today, the most common treatment for PCO is laser surgery.

During laser surgery, a surgeon punctures a hole in the posterior capsule, which restores clear vision in most people. The procedure takes about 5 minutes to complete. It should restore a person’s vision within 24 hours.

However, the procedure is not cost-effective and may not be a viable option for all people.

Researchers are currently looking into other options, but more research is needed to prove their effectiveness and safety for many people.

Read more about Medicare and laser surgery.

Changing surgical techniques may also help prevent PCO.

A person who experiences cloudy vision that developed after cataract surgery, even a few years later, should consider talking with an optometrist or eye doctor. They can help determine whether someone has developed PCO.

After cataract surgery, it is essential for people to follow all instructions from their doctor to help aid recovery.

A person can consider reaching out to a doctor if they experience continued symptoms after cataract surgery, such as seeing:

  • hazy vision
  • shadows
  • starburst patterns around lights
  • halos
  • glare

Cataract surgery may cause adverse reactions and complications during and after surgery. In some cases, complications may appear years later.

During surgery, common complications include:

  • bleeding inside the eye
  • lens fragments falling deep inside the eye
  • floppy iris syndrome
  • posterior capsule rupture
  • iris or ciliary body injury

After surgery, common complications can include:

Cataract surgery will not fix vision issues due to other underlying causes. If a person still experiences vision issues after recovering from cataract surgery, they may need treatment for other eye conditions, such as:

Cataract surgery can greatly improve vision. However, a common complication is PCO, when the transparent membrane becomes opaque, leading to cloudy or blurry vision.

A person can consider talking with a doctor if they develop cloudy vision after cataract surgery or if their vision does not improve. They may need additional therapies or treatments to help restore their sight.

Laser surgery is currently the preferred method to treat PCO, though other potentially effective therapies are under investigation. Advances in modern cataract surgery techniques may also be effective in preventing PCO.