What complications are possible after cataract surgery and how dangerous are they? Repeated cataract (secondary) after lens replacement surgery After 6 months of cataract surgery, midges appeared.

Cataracts are an unpleasant disease, but nevertheless curable. Often, however, it is necessary to use surgical techniques to cope with it. But such intervention is not always successful and does not lead to a number of problems. And in certain situations, so-called secondary cataracts occur after lens replacement, which also requires treatment. How to proceed in this case?

What it is?

The usual so-called primary cataract develops due to clouding of the substance located in the lens. Treatment involves the intervention of surgeons - the natural lens will need to be replaced with a special lens. During the operation, one of the walls of the lens capsule is carefully excised, the affected lens is removed, and a new, artificial one is placed in its place. The first such operation was carried out in 1950 in Great Britain.

However, after surgery to rid the patient of this pathology, cataracts may appear again. But where does it come from if the lens has already been removed? The fact is that the lens capsule, which is quite soft and elastic, is not removed during surgery - a special intraocular lens is placed in it. And the walls of the remaining posterior capsule simply thicken and become overgrown with epithelium - in a healthy eye they are very thin, and thickened walls in an eye affected by cataracts and operated on lead to blurred vision. It’s just that light rays can no longer freely penetrate all the structures of the eye and reach the retina.

This is how a pathology called secondary cataract. The symptoms are very similar to the usual one, but in fact this is not a returning primary cataract, since the nature of the pathologies varies. The secondary type develops only after surgery to treat the primary.

On a note! Secondary cataracts usually occur in 30% of people who have had cataracts. Typically, the pathology develops within 6-18 months from the date of surgery.

Most often, secondary cataracts occur in people who suffered from the disease at a young age. In older patients, fibrosis of the lens capsule usually develops instead. Sometimes the incidence of the disease can be greatly influenced by the material and type of artificial lens implanted in the eye. For example, it appears more often from acrylic lenses than from silicone lenses.

Table. Types of secondary cataracts.

Symptoms

There are not many symptoms of secondary cataracts, but it is thanks to their appearance (sometimes gradual) that it is possible to identify the developing disease in time. Signs include:

• deterioration in the quality of vision (gradual);
• blurred vision;
• change in color perception - all objects acquire yellowish tints;
• duality of the image, its distortion;
• increase in the level of photosensitivity;
• the appearance of black or white dots before the eyes;
• inability to correct vision with glasses;
• the appearance of glare in the eyes;
• the appearance of a cloudy focus on the pupil - a gray speck (in certain cases).

It is after the operation that it is impossible to say that a person may develop cataracts. And even improved vision does not guarantee the absence of its development. Therefore, it is very important, especially in the first year after surgery, to monitor your condition and, at the slightest sign of the development of secondary cataracts, go to the doctor.

Reasons for development

Secondary cataract is a fairly common complication. It can have several forms and each has its own reasons for its development.

Fibrosis of the posterior capsule is caused by the active development of epithelial cells, which is why the capsule becomes compacted. Visual acuity is significantly reduced. To call this pathology a pure secondary cataract would be somewhat incorrect.

May also develop pearly dystrophy, which is called secondary cataract. It occurs frequently, but its cause is the formation of defective lens fibers, which are called Adamyuk-Elschnig balls. Such fibers migrate over time into the central optical part and create cloudiness in the eye. Vision deteriorates due to the inability of light to pass through the lens capsule.

On a note! The development of secondary cataracts can be caused by diabetes mellitus, rheumatoid arthritis, etc. If performed incorrectly, it can also cause complications.

Risk factors that provoke the development of cataracts include:

• young age of the patient;
• eye injuries;
• inflammatory and non-inflammatory diseases of the organs of vision;
• metabolic problems;
• negative habits and unhealthy lifestyle;
• poisoning;
• heredity.

Treatment methods and diagnosis

If signs of cataract development appear, you should immediately visit an ophthalmologist. The doctor will conduct a diagnosis and determine whether the pathology is really developing or whether the deterioration in vision is caused by some other reasons.

Diagnostics includes:

• checking vision clarity;
• biomicroscopic eye examination using a special slit lamp. It will help determine the type of clouding of the capsule and will reveal the absence or presence of edema or any inflammation;
• measuring pressure inside the eye;
• fundus examination, which will reveal retinal detachment and a number of other problems;
• if macular edema is suspected, the doctor performs angiography or coherence tomography.

Treatment of secondary type cataracts can be done in two ways - laser and surgical. In the second case, the cloudy area is excised. The technique is applicable if secondary cataract has caused the development of a number of serious complications that threaten complete loss of vision. Previously, treatment was carried out only in this way, but over time it became possible to correct the pathology using laser technology.

Laser correction is a safe and simple method that does not threaten a person with the development of any complications and does not require a number of complex studies. The technique appeared and began to be used in 2004, it is called laser capsulotomy, is non-invasive and painless.

As a rule, a special laser is used to perform capsulotomy, powered by the so-called yttrium aluminum garnet with neodymium. Doctors call it a YAG laser (Latin abbreviation YAG). This laser is capable of destroying clouded tissue, anesthesia is performed by drip, and the procedure lasts no more than 10-15 minutes. Vision returns to normal immediately after treatment, the patient will be able to go home even while driving.

Contraindications

Fortunately, this operation has virtually no contraindications. However, it may be rescheduled due to a number of aspects:

• with corneal edema;
• due to cystoid edema of the macular area;
• for a number of pathologies of the retina or macula;
• for inflammatory diseases of the eyeball;
• due to a number of changes in the cornea, including its edema.

Prevention after surgery

The patient needs to monitor his health after routine cataract surgery on his own. Only if you follow all the recommendations of the ophthalmologist will you be able to protect yourself as much as possible from the development of complications. For example, for 4-6 weeks the patient must instill special eye drops that will protect them from the development of inflammatory processes. Lifting heavy objects, rubbing your eyes with your hands, or moving suddenly is also not a good idea. It is forbidden to go to the pool, bathhouse or sauna, play sports, or apply makeup.

Laser cataract correction can also be accompanied by complications if eye care rules are not followed. It is important to monitor eye pressure for 30-60 minutes immediately after surgery. If the pressure is normal, then the person simply goes home, where he independently carries out antibacterial and anti-inflammatory therapy for the time indicated by the doctor.

Attention! One of the most common complications after surgery is anterior uveitis. But it usually develops in the absence of proper care and non-compliance with doctor’s recommendations.

In the first weeks after surgery, “” may appear before your eyes, but you should not worry about this. They appear due to the fact that the remains of a destroyed lens capsule fall into a person’s field of vision. But if the spots do not disappear, then you need to visit a doctor. Decreased visual acuity should also cause concern.

How to prevent the development of cataracts

Sometimes preventing a disease is much easier than curing it. Let's look at how you can reduce the risk of developing cataracts in general.

Step 1. It is important to protect your eyes from the sun. Exposure to sunlight without eye protection for a long time is dangerous - it can cause the development of cataracts or even eye cancer. It is better to wear a Panama hat with a visor on your head, and sunglasses on your eyes. During the day, if possible, it is not recommended to be in the sun between 11 a.m. and 3 p.m.

Step 2. It is recommended to lead a healthy lifestyle, give up alcohol and cigarettes. Substances that the body receives due to bad habits can reduce the body’s regenerative processes and have a negative effect on the body as a whole.

Step 3. You need to eat right, include as many vegetables and greens in your menu as possible, as well as foods rich in vitamins E and C. The antioxidants contained in greens are good preventatives against cataracts.

Step 4. Doctors often associate cataracts with diabetes, which, in turn, is associated with obesity. Therefore, it is important to monitor your weight and exercise.

Step 5. Regular examinations by an ophthalmologist are required. In this case, the disease can be detected in the early stages and treatment will be easier.

Step 6. If you experience any symptoms of cataracts, it is important to see a doctor immediately.

Step 7 In your activities, it is important to use glasses and other means that help prevent cataracts and prevent its further development if it has already appeared.

Video - Treatment of secondary cataracts

Secondary cataracts do not always occur. And, fortunately, it is not difficult to cure it now. The main thing is not to start the development process and consult a doctor in time at the first symptoms of its appearance.

Secondary cataract after lens replacement can be diagnosed as a complication, so its treatment should be urgent. Such negative consequences occur in approximately 20% of patients who have already undergone treatment of the ocular apparatus. Due to the relevance of this topic, we would like to consider the features of secondary cataracts, its causes, symptoms and treatment methods.

Secondary cataracts cause the lens to harden and become cloudy. Usually after surgery this capsule remains intact. The only exceptions are patients who have had severe eye trauma. The capsule is an elastic bag into which an artificial lens is placed. Surgeons insert an IOL into it so that a person can see normally after removing the lens.

Over time, epithelium begins to grow on the back surface of the capsule, which reduces the transparency of the lens and contributes to the deterioration of visual acuity.

Primary or late cataracts may appear. The first type occurs immediately after surgery; it usually goes away on its own within a few hours. Late cataracts become noticeable 1-2 months after removal of the lens. It develops gradually and has mild symptoms.

Most people believe that secondary cataracts develop only due to medical error. However, this is just a misconception. The epithelium begins to grow due to cellular reactions occurring in the capsule. This violation occurs even if the operation was completed successfully.

Causes of pathology

Currently, doctors cannot identify the exact conditions under which the disease occurs. It is known that clouding is recognized as a natural process that begins due to age-related changes in the body.

The causes of secondary cataracts after lens replacement may be due to one or more factors. Contributes to the development of the disease:

1. A genetic predisposition that can only be inherited from close relatives.
2. Mechanical or chemical injuries to the ocular apparatus suffered after surgery.
3. High levels of radiation in the patient's place of residence or work.
4. Myopia, farsightedness or high degree glaucoma.
5. Pathological changes in metabolism that contribute to the development of diabetes mellitus or vitamin deficiency.
6. Prolonged exposure to the sun without protective glasses.
7. Abuse of alcohol or smoking.
8. Excess of toxic substances in the body.

Symptoms

After removal of the cloudy lens, patients' visual acuity increases, but this does not guarantee that secondary cataracts will not appear. A decrease in visual acuity is a very rare occurrence with the repeated development of the pathology, so you should not rely only on this symptom.

It is best to regularly monitor how your eyes react to light and how well the visibility of objects remains in the dark.

Recurrent cataracts after lens replacement can be detected due to symptoms such as:

• feeling of discomfort or even pain in the eyes;
• the appearance of photophobia;
• development of myopia;
• the appearance of a small veil before the eyes;
• dual image;
• change in color perception.

As the clouding progresses, the patient may find it difficult to read or use a computer. Secondary cataracts can occur in two eyes at the same time or in just one. The development of the disease occurs up to 10 years. It is very difficult to notice visually, which is why it is so important to regularly visit an ophthalmologist after cataract removal.

Surgical intervention

If secondary cataracts after lens replacement have been diagnosed and confirmed by a doctor, then depending on the patient’s condition, the specialist will select the optimal treatment method.

Elimination of disturbing symptoms is possible only through capsulotomy. During this procedure, the central optical part is cleared of cloudiness. The treatment process can be carried out using a laser or mechanical action. To begin with, I would like to tell you in more detail about how the surgical intervention proceeds.

It should be noted that the surgical approach is used extremely rarely due to the high risk of complications. During the operation, the specialist uses a special knife to cut through the cloudy film. Surgeons will make cross-shaped incisions, the diameter of which does not exceed 3 mm.

Such an operation is considered necessary in cases where repeated cataracts have caused severe complications and there is a risk of complete loss of vision. Surgical treatment of secondary cataracts after lens replacement can be performed in adults and children. The cost of such an operation usually does not exceed $90.

Laser therapy

A more innovative method of treating this disease is the use of a special laser. Patients are prescribed this procedure for clouding of the lens capsule, high sensitivity to light and damage to the capsule wall. The high precision of the laser allows you to minimize all complications and significantly shorten the postoperative period.

During discision, the laser makes a small hole in the posterior wall of the capsule through which the opacification is removed.

Laser treatment of secondary cataracts requires local anesthesia. The procedure itself is carried out in 3 stages:

1. Pupil dilation. To do this, special drops are instilled into the patient before the operation. This may be cyclopentanol, tropicamide or phenylephrine.
2. Normalization of intraocular pressure. To ensure intraocular pressure remains within normal limits after surgery, doctors use apraclonidine.
3. The laser fires several shots, after which the cloudy capsule becomes transparent.

Contraindications include the presence of swelling, inflammation and thickening of the pupil membrane. Prices for such an operation can vary within $200.

Possible complications

Surgical and laser therapy differ from each other in that in the first case there is a high risk of complications. None of the presented methods allows you to completely protect yourself for the future, but when choosing laser treatment, patients encounter negative consequences much less often.

Sometimes inflammation begins in the body due to injury (surgery). To prevent this, doctors give patients antibiotics or steroid drugs during the final stage of cataract removal. If the prescribed medications help, then all the discomfort will disappear in 2-3 days.

If the iris or artificial lens is injured, hemorrhage may occur in the anterior chamber of the eye. This complication is extremely rare and disappears completely within 3 days. The patient is prescribed special medications that promote this process. If the drugs become ineffective, another operation is performed. During this procedure, the doctor additionally rinses the camera and fixes it.

Sometimes removal of a secondary cataract leads to displacement of the lens. This complication will negatively affect the functioning of the eye apparatus. A person may complain of rapid eye fatigue, doubling of objects and a constant feeling of discomfort. This pathology can only be treated with surgery, during which the position of the lens is corrected.

To minimize the risk of developing secondary cataracts, you must strictly follow all doctor’s recommendations, limit physical and visual activity, and also eat right.

The lens capsule is elastic. During cataract surgery, an artificial lens is placed in the eye to replace the real one. In this case, the posterior capsule serves as a support for the new one. It happens that the capsule begins to become cloudy, which causes a phenomenon such as secondary cataracts after replacing the lens. Treatment, the reviews of which are the most positive, is carried out in accordance with medical indications. The latest methods and high-quality equipment are used.

Causes of the phenomenon

Where does secondary cataract appear after lens replacement? Reviews from doctors about this complication indicate that the exact reasons for its occurrence have not been 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. This process cannot in any way be associated with a surgeon’s mistake during the operation. Secondary cataracts after lens replacement, the causes of which lie in the body’s reaction at the cellular level, are a fairly common phenomenon. Lens epithelial cells turn into fibers that are functionally defective, irregular in shape, and opaque. When they move to the central part of the optical zone, clouding occurs. Visual impairment may be caused by fibrosis of the capsule.

Risk factors

Ophthalmologists have identified a number of factors that explain why secondary cataracts appear after lens replacement. These include the following:

• Patient's age. In childhood, cataracts occur more often after surgery. This is due to the fact that tissues in a young body have a high level of regeneration capacity, which causes the migration of epithelial cells and their division in the posterior capsule.
• IOL shape. The square-shaped intraocular lens allows the patient to significantly reduce the risk of damage.
• IOL material. Doctors have found that after the introduction of acrylic-based IOLs, secondary lens opacification occurs less frequently. Silicone structures provoke the development of complications more often.
• The presence of diabetes mellitus, as well as some general or ophthalmological diseases.

Preventive measures

To prevent the appearance of secondary cataracts, doctors use special methods:

• The lens capsules are polished to ensure maximum cell removal.
• A selection of specially designed designs is made.
• Medicines are used against cataracts. They are instilled into the eyes strictly for their intended purpose.

Signs of secondary cataracts

In the early stages, secondary cataracts may not manifest themselves at all after lens replacement. The duration of the initial stage of disease development can range from 2 to 10 years. Then obvious symptoms begin to appear, and there is also a loss of objective vision. Depending on the area in which the lens deformation occurred, the clinical picture of the disease can vary significantly.

If a secondary complication manifests itself on the periphery of the lens, then it may not cause visual impairment. As a rule, pathology is detected during a routine examination by an ophthalmologist.

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

In addition to the symptoms described above, monocular doubling of objects may occur. The closer to the center of the lens the cloudiness is located, the worse the patient's vision. Secondary cataracts can develop in one eye or in both eyes. Distortion of color perception appears and myopia develops. External signs are usually not observed.

Treatment

Secondary cataracts after lens replacement, which are successfully treated in modern ophthalmology clinics, are removed by capsulotomy. This manipulation helps free the central zone of the optics from clouding, allows light rays to enter the eye, and significantly improves the quality of vision.

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

Surgical intervention

How is secondary cataract of the lens eliminated? Treatment involves surgery. This surgical intervention involves dissection or excision of the clouded film using a surgical knife. Manipulation is indicated in cases where secondary cataracts after changing the lens have caused major complications, and there is a possibility that the patient will go blind.

During the operation, cross-shaped incisions are made. The first is done in the projection of the visual axis. As a rule, the hole has a diameter of 3 mm. It may have a higher value if examination of the fundus of the eye is needed or photocoagulation is required.

Disadvantages of surgery

The surgical method is used for both adult patients and children. However, a fairly simple operation has a number of significant disadvantages, which include:

• infection entering the eye;
• 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 cataract of the lens? Treatment is carried out using laser beams. This method is highly reliable. It requires precise focusing and low energy consumption. As a rule, the energy of the laser beam is 1 mJ/pulse, but if necessary, the value can be increased.

Laser intervention is called discision. 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, the clouded capsule is removed. For this method we use a YAG laser. In modern medicine, this method is preferred.

Reviews from patients indicate that such an intervention does not require a hospital stay, the operation is very quick and does not cause pain or discomfort. Manipulations are carried out using local anesthesia.

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

• Pupil dilation with medications. Eye drops are applied to the cornea to dilate the pupils. For example, tropicamide 1.0%, phenylephrine 2.5%, or cyclopentolate 1-2% are used.
• To prevent a sharp increase in pressure inside the eye after surgery, apraclonidine 0.5% is used.
• Firing several laser shots using a special device mounted on a slit lamp causes a transparent window to appear in the cloudy capsule.

How does a person feel after laser removal of such a phenomenon as secondary cataract after lens replacement? Reviews from patients indicate that after the operation they went home within a few hours. No stitches or bandages are required for this intervention. Patients are prescribed hormonal eye drops. Their use in the period after surgery will be the last step on the path to vision restoration.

After a week, the person who has undergone surgery will have a routine examination by an ophthalmologist to make sure everything is going correctly.

Another examination is indicated a month later. It is not considered planned, but passing it is desirable. This way you can identify possible complications and eliminate them in a timely manner. It should be noted that the overwhelming number of complications occur within a week. Later they occur extremely rarely.

For the most part, secondary cataracts are eliminated with a single laser surgery. Secondary intervention is performed extremely rarely. The likelihood of complications from this type of treatment is very small and is about 2%.

In what cases is discretion prescribed?

Discision of secondary cataract is used if:

• a damaged posterior stack of the capsule causes a sharp decline in vision;
• poor vision interferes with the patient’s social adaptation;
• problems appear with seeing objects in excessive or poor lighting.

Strict contraindications

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

• the presence of swelling or scar tissue in the cornea, which prevents the ophthalmologist from clearly seeing the intraocular structures during surgery;
• the occurrence of an inflammatory process in the iris of the eye;
• presence of a retina;
• clouding of the cornea;
• the thickness of the pupil membrane exceeds 1.0 mm.

Relative contraindications

Relative contraindications include conditions in which the risk of secondary complications is increased:

• the period of surgical intervention to remove cataracts for pseudophakia is less than six months, and for aphakia less than 3 months;
• complete contact of the posterior capsule with the IOL;
• pronounced process of neovascularization of the pupil membrane;
• presence of uncompensated glaucoma;
• the presence of inflammatory processes in the anterior segment of the eye.

The operation is performed with great caution if the patient has previously experienced retinal detachment or rupture.

The laser treatment method has its drawbacks. 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 secondary cataracts, black spots may appear, which is caused by damage to the structure of the lens during surgery. This defect has no effect on vision. This type of damage is caused by poor focusing of the laser beam.
• Retinal cystoid edema is considered a dangerous complication. In order not to provoke its appearance, surgical intervention should be carried out only six months after the previous operation.
• eyes. This phenomenon is extremely rare and is caused by myopia.
• Increase in IOP level. Usually this is a quickly passing phenomenon and does not pose any threat to health. If it continues for a long time, this indicates that the patient has glaucoma.
• Subluxation or dislocation of the IOL is observed in rare cases. This process is usually caused by IOLs with a silicone or hydrogel base with disc-shaped haptics.
• The chronic form of endophthalmitis is also uncommon. It is caused by the release of isolated bacteria into the vitreous area.
• Fibrosis (subcapsular opacification) is rare. Sometimes this process develops within a month after the intervention. An early form of the complication can provoke contraction of the anterior capsule and the formation of capsulophimosis. Development is influenced by the model and material from which the IOL is made. Often this deviation is caused by silicone models with haptics in the form of disks and, less commonly, 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 using eye drops to prevent the development of cataracts.

Conclusion

From all of the above, we can conclude that after cataract surgery, a complication such as secondary cataract of the lens often occurs. Treatment of the disease using modern methods gives good results, but side reactions are also possible.

Secondary cataract develops as a complication after the main operation. The reasons for the occurrence are that the epithelium becomes denser with the implant.

There is a sharp decrease in visual activity. After lens replacement, almost 20% of patients develop the presented pathology.

Treatment

Secondary cataracts after lens replacement significantly complicate a person’s life and activities. The disease requires urgent surgical treatment.

It involves the use of laser or other surgical technology.

Laser removal

An available method for treating secondary cataracts is YAG lasers. The posterior compartment of the lens capsule is burned with a beam. Turbidities are eliminated. The procedure is painless, complications are minimal.

Surgical technology

Removal of secondary cataracts after lens replacement is carried out using a microsurgical technique - phacoemulsification. Ultrasonic equipment is used and the core is grown. The procedure is effective and safe.

The wall barrier of the capsule is incised, a phacoemulsifier (a mechanism that grows the nucleus) is introduced, and damaged fragments are removed.

Ultrasound eliminates the cloudiness, and a lens with a similar optical effect is installed. Surgery is permissible on one or two eyes, even with different stages of secondary cataract.

Advantages of the technique:

• carried out in laboratory conditions, duration 30 minutes;
• local anesthesia is used;
• no pain or stitches;
• rapid regeneration of the skin;
• return to normal activity after 7 days;
• restoration of visual functions 5-6 hours after surgery.

Phacoemulsification is indicated for patients of any age.

Drug treatment

After surgery, the patient needs to stabilize his metabolism. To restore the functionality of the eye lens, eye drops are prescribed, which contain magnesium and potassium salts. At the initial stage of secondary cataracts, hormonal drugs in combination with vitamins are indicated.

Secondary cataract after lens replacement on video:

Laser dissection

One of the effective methods of combating the development of secondary cataracts is laser discision. 30 years have passed since the first operation.

Since then, laser treatment of the eye organs has become quite popular. Advantage: minimal percentage of side effects and complications.

The operation is indicated for patients with:

• a sharp decrease in visual function;
• clouding of the lens capsule;
• decreased visual activity in the presence of bright light or poor lighting.

Discretion does not apply to patients with:

• inflammatory reactions of the iris;
• the presence of scar tissue connections in the cornea area;
• swelling of the mucous membrane;
• molecular retinal hematoma.

Treatment is prescribed after a diagnostic examination.

The operation is performed under local analgesics. The patient does not feel pain or discomfort.

Removal of recurrent cataracts:

1. Drops are applied to the eyeball area to help dilate the pupils. Phenylephrine, Tropicamide, Cyclopentolate are used. With the help of medications, the visibility of the posterior capsule is improved.
2. Laser pulses are directed to the posterior part of the lens capsule;
3. Epithelial growths are burned out;
4. The walls become transparent. Visual function is restored.

To prevent intraocular pressure, the patient is prescribed Apraclonidine.

Contraindications

Surgery is not indicated for all patients. In the presence of certain pathologies, surgery is not performed.

These include:

• infectious lesions;
• congenital pathologies of the eye organ, infectious diseases;
• oncological formations in the eye area.

Contraindications to surgical measures:

• high pressure;
• epilepsy;
• Congenital heart defect;
• renal failure;
• brain injuries;
• cancerous tumors of different locations.

Removal of repeated cataracts is prohibited in case of diabetes mellitus and in children under 18 years of age. The doctor conducts diagnostics, reviews the results, and makes a decision on whether to perform an operation personally for each patient.

Recurrent membranous cataract

Secondary membranous cataract is a seal located on the posterior wall of the lens capsule. The indicators lead to a sharp deterioration in visual function. The capsule is a fragile sac containing the natural or artificial lens.

Reasons for the formation of secondary cataracts: spontaneous resorption of the lens as a result of injury or surgery. In its place remains the front or back wall with a wide, cloudy film.

Repeated membranous pathology is removed surgically. The central section is dissected using a laser or a special knife. An artificial lens is inserted into the hole.

Complications

Secondary cataract is characterized as a complication after primary cataract surgery. The presented ophthalmological pathology is treated surgically or laser. The clouded lens is removed and an artificial lens is implanted.

In some cases, surgical procedures are accompanied by complications:

1. Injury to the artificial lens. This is usually the result of poor calibration of laser equipment or incorrect beam focusing.
2. Swelling of the molecular retina. The consequences are caused by a significant load on the visual organ. To avoid the presented consequences, it is recommended to perform the operation no earlier than a year after the first cataract surgery.
3. Retinal detachment. The complication occurs in rare cases. Reasons: medical errors or restrictive laser coagulation.
4. Implant displacement. With laser treatment, the likelihood of this complication is negligible. The disruption occurs during surgery.
5. Increased intraocular pressure. Causes: clogged drainage of the eye organ. To eliminate the complication, drops are prescribed to stabilize blood pressure. In rare cases, the anterior chamber compartment is washed or punctured.

Cases have been recorded where secondary cataracts are complicated by astigmatism (myopia). An intraocular lens is implanted. Contact optics specifically combats the manifestation of cataracts and astigmatism.

Why it occurs - reasons

The lens is covered by a transparent membrane, similar to a sac. From there, the fluid is removed and the implant is inserted. Some time (4 - 5 months) after surgery, the epithelium grows on the posterior part of the capsule.

There is a decrease in transparency, which leads to loss of visual activity. Reasons for the development of secondary cataracts: insufficient functioning of cellular structures.

Why does the disease occur, what contributes to its development:

• age-related changes (aging);
• genetics;
• eye injuries;
• concomitant pathologies (glaucoma, astigmatism);
• irradiation;
• frequent exposure to sunlight;
• poisoning;
• nicotine, alcohol.

• use of disinfectants;
• It is forbidden to sleep on the stomach and side (where the operated organ is located);
• prevent contact (in the area of ​​the eyeball) with aqueous substances and detergents;
• reduce physical activity;
• stop driving a car.

Secondary cataracts are treatable. Don't put off going to the doctor.

Symptoms

Repeated pathology develops over months, in some cases – several years. The time cycle depends on age criteria and the installed implant (its quality).

When using acrylic lenses, recurrent disease progresses less frequently than when using silicone lenses. Often the first symptomatic manifestations occur in older people or children.

There is a sharp decrease in visual activity, the sensitivity of color ranges disappears.

If there is a sharp improvement, and after a few days a decrease in visual activity, it is recommended to consult your doctor. The symptom indicates the development of recurrent pathology.

The main symptomatic manifestations include:

• split image;
• visibility of circular images;
• surrounding objects appear in yellow shades;
• vagueness of letters and numbers.

The pathology is characterized by gray or yellow tones of the pupil. Increased sensitivity to bright or dim light. If you have these symptoms, it is recommended to consult an ophthalmologist.

Diagnostics

Instrumental and laboratory diagnostics are used for the examination. The doctor performs an ophthalmological examination using a slit lamp. The transparency of the posterior capsule is visible. Stimulants are introduced to improve the visibility of the veil.

In addition, it is prescribed:

1. Visometry. The level of visual acuity is determined.
2. Biomicroscopy. Cloudiness of the optical compartments and abnormal modifications of the anterior ocular area are visualized.
3. Ultrasound A and B mode. The physiological characteristics of the visual organ and the position of the IOL are assessed.
4. Coherence tomography. Additionally, the topography of the eyeball and intraorbital structures are diagnosed. Pathological transformations of the posterior chamber barriers are revealed (connective tissue film coating, concentration of rings, cellular structures).

The instrumental diagnostic method is effective for pronounced modifications of the lens capsule. Laboratory testing is prescribed at the initial stage of pathology formation. Diagnostics will make it possible to predict the risk of developing nosology.

Therefore, an additional laboratory test is prescribed:

1. Measuring cytokine levels. The methodical course is characterized by hybridization and immunofluorescence. The level of cytokines in the blood that provoke inflammation during the postoperative stage is determined.
2. Antibody testing. If there is an excess of antibodies in the circulatory system, then there is a risk of recurrent cataracts.
3. Film diagnostics. Cells are detected 90 days after surgery. They indicate long-term progression of secondary cataracts.

Diagnostic measures allow timely detection of the development of secondary cataracts. Timely diagnosis and proper treatment contribute to a quick recovery. Their absence leads to frequent relapses, complete or partial blindness.

Prognosis and preventive actions

If repeated surgery is performed correctly, the prognosis is positive. The patient notices a noticeable improvement in the quality of vision within a week. However, complications have not been canceled.

The most common ones that may occur are:

• damage to the lens by a laser beam, which occurs due to insufficient qualifications of the doctor and improper adjustment of the equipment;
• the development of panophthalmitis, which is associated with microbes entering the eye;
• intraocular hemorrhage that occurs due to vascular damage.

The doctor should warn that glaucoma, retinal detachment or swelling may occur. However, such serious complications arise only in the absence of timely treatment.

The main preventive measure, which is always effective, is timely consultation with an ophthalmologist. In case of any alarming symptom, the patient should contact a specialist for competent advice.

This article is for informational purposes only, and only an ophthalmologist can prevent the development of secondary cataracts in a timely manner.

Among the preventive measures is the competent use of drops. Drugs such as Oftan Katahrom and Quinax minimize the risk of cataracts. Within 1-2 weeks after surgery, it is necessary to resort to the use of protective measures. Thus, the patient should not read from electronic devices, spend a lot of time at the computer, or look at bright light sources without suitable protection.

Ophthalmologists recommend undergoing consultation and examination at least once every 2 months for a year after surgery. Then the likelihood of timely detection of the disease will be higher. The use of preventive measures, coupled with timely consultation with an ophthalmologist, reduces the risk of cataract progression to zero.

Recurrence of the disease after removal of the lens is not excluded, but this problem will not arise if the doctor and patient make every effort to combat it in a timely manner.

What will happen if the pathology is not treated?

Since the lens has a very delicate epithelium, the entire impact will first be on the inner membrane.

Lack of timely treatment can lead to the following consequences:

• partial or complete loss of vision;
• retinal pathologies caused by inflammation of the epithelium;
• diplopia caused by deterioration of the elasticity of the capsule.

Secondary cataracts will not return after lens replacement if you follow these recommendations:

1. You should not visit the pool or swim in the river for a month.
2. In the summer season, avoid direct sunlight on the iris of the eye and do not sunbathe in open areas.
3. Change the load on your eyes periodically: your main task is not to overstrain your optic nerves.
4. Women are advised to avoid wearing cosmetics after surgery. Wash your face with baby soap.

After the operation, the patient undergoes a rehabilitation course, which includes eye exercises, taking medications and regular visits to the doctor. The main thing in every person’s life is a healthy outlook on the world!

Rehabilitation

Treatment of secondary cataracts after lens replacement also includes a rehabilitation period. At this time, the person must use the prescribed drops and follow all the doctor’s recommendations.

To avoid the development of anterior uveitis (a common complication of laser discision), the patient is prescribed antibacterial and anti-inflammatory drugs. A person should instill them into the operated eye daily, 3-4 times a day. Medicines help relieve inflammation, which often occurs after surgery.

A common complication of laser discision is increased intraocular pressure (IOP). In order to identify and eliminate the problem in time, the patient undergoes tonometry 30 and 60 minutes after the manipulation. Doctors prescribe antihypertensive drops to all patients with concomitant glaucoma or a tendency to ocular hypertension.

How long does it take to treat the disease?

If you consult a doctor in a timely manner, treatment is quite simple and in a short time. In the case of using a laser, the patient returns home the same day. With phacoemulsification, the doctor decides when to send the patient home, but more often this is a period of 7-10 days. Treatment of secondary cataracts in the early stages will allow the patient to quickly return to their normal lifestyle and not experience discomfort.

4.6 / 5 ( 9 votes)

Floaters before the eyes are single or multiple dark spots, especially clearly visible against a uniform light background (white, blue). As a rule, people notice them only at the beginning of their appearance, but over time, having gotten used to the presence of spots, they completely stop paying attention to them. But in vain, because such seemingly harmless flies in some cases can become a real problem for vision!

One of the reasons for the appearance of flying flies may be the destruction of the vitreous body; it is the opacities that arise in it that cast shadows on the retina. Such opacities, as a rule, consist of blood clots, dead cells, protein, crystals, and pigment. Moreover, the closer the opacities are to the surface of the retina, the more noticeable their shadows are for a person and the more clearly he sees the floaters. In response to eye movements, the flies quickly move, and then slowly (about 10 seconds) return back.

Elderly people, as well as patients who have undergone cataract surgery and people with myopia, especially often suffer from floaters in their eyes.

Other causes of floaters before the eyes

Destruction of the vitreous body (which results in the appearance of floaters) can also be caused by a number of other reasons:

• Low or high blood pressure;
• Cerebrovascular accident;
• Spasms of blood vessels in the head or eyes;
• Fragility of the walls of blood vessels;
• Consequences of injuries and operations of the head or eyes;
• Stroke;
• Intraocular infections and inflammation processes;
• Metabolic disease;
• Long-term eye strain;
• Severe emotional or physical stress;
• Prolonged hypoxia (lack of oxygen);
• Deficiency of certain vitamins;
• Bad habits (smoking, alcohol, drugs);
• Liver and gastrointestinal diseases.

Often the appearance of flying flies is caused by a rupture or detachment of the retina or vitreous body. In this case, so-called “lightning flashes” are added to the flying floaters, which arise due to voids formed in the vitreous body. If floaters appear before your eyes, you should consult an ophthalmologist. After conducting an examination, the specialist will definitely suggest a way to solve the problem or give a referral for a full medical examination if the cause of the floaters lies in the pathology of other organs.

What do flies look like?

The type of vitreous destruction is directly related to the appearance of fly flies:

• Filamentous destruction. It is caused by necrosis and compaction of individual collagen fibers due to deterioration of metabolic processes and the development of pathology in the vitreous body. In this case, a person sees cobwebs, stripes and threads. Liquefaction of the vitreous can cause its fibers to stick together, forming branched weaves that look like spiders, octopuses, jellyfish, etc.
• Granular destruction. It occurs due to the penetration of hyalocytes - cells that form the fibers of the vitreous body into its internal space. Over time, hyalocytes become denser and die, taking on clear outlines, visible as black dots, circles, rings, etc.

Treatment for flying flies

Practice shows that drug treatment for floaters before the eyes is not particularly effective. In the case of small opacities, visible as small black dots, absorbable drops containing potassium iodide, as well as drops with vitamins (for example, Taufon or Quinax), are usually prescribed. If there are a large number of flies that interfere with vision, complex therapy may be required to accelerate the metabolic processes of the vitreous body (using drugs such as Wobenzym and Emoxipin).

Often floaters go away spontaneously, in some cases drug treatment helps, but usually they still remain.

What is truly effective in combating floaters is surgical treatment. This treatment is not widespread everywhere and is associated with a number of possible complications that can lead to blindness. To get rid of the destruction of the vitreous body, 2 types of operations are used:

• Vitreolysis is a procedure performed using a YAG laser, the beam of which is targeted at opaque fragments, literally breaking them into very small particles that can no longer interfere with vision.
• Vitrectomy is an operation of complete or partial removal of the vitreous body and floaters along with it. However, to carry out this serious operation there must be very strong indications.

It is worth remembering that surgical treatment of vitreous destruction will help get rid of a harmless interference with vision, but can cause much more serious problems, for example, retinal detachment and cataracts.

A much less problematic way to deal with flying flies can be to change your lifestyle. Exercising, giving up bad habits, a balanced diet and certain eye exercises may well help get rid of this annoying hindrance. In addition, you should carefully monitor your health and consult a doctor if you experience any ailments, especially if it concerns your eyes.

One of the leading ophthalmological centers in Moscow where all modern methods of surgical treatment of cataracts are available. The latest equipment and recognized specialists are a guarantee of high results.