Can Cataracts Come Back? Understanding Secondary Cataracts

Will my cataracts grow back?

Cataract surgery is one of the most common vision-restoring procedures performed worldwide. It provides long-term improvement in sight for most people, but many patients still wonder: can cataracts come back? The short answer is no. Your original cataract will not return!

What some people experience after surgery is something called a secondary cataract, also known as posterior capsular opacification (PCO).¹ While it can also affect your vision, it’s not a true cataract and it can be easily treated.

Key Points

• Cataracts themselves don’t come back once the cloudy natural lens is removed.
• Some patients develop a secondary cataract, known as posterior capsular opacification (PCO), which can cause blurry vision but is easily treated.
• Keeping up with follow-up visits helps catch any issues early and keeps your vision sharp.

Can Cataracts Come Back After Cataract Surgery?

When cataracts make your natural eye lens cloudy, you may notice decreased vision and other visual symptoms. A common solution is to remove the cataracts with surgery. During this procedure, the cloudy lens is swapped out for a clear artificial lens called an intraocular lens (IOL).¹

Since your natural lens is taken out, cataracts can’t actually come back. However, some folks may develop posterior capsular opacification (PCO), which can create cloudy patches or blurry vision similar to the original symptoms. That’s why it’s easy to confuse PCO with cataracts making a return. 

Studies suggest that about 20% to 50% of people might experience PCO within a few years after surgery.^1,2 

Understanding Cataracts and Your Natural Lens

Cataracts form in your eyes when the proteins in your natural lens break down and clump together. This creates cloudy vision that gets worse over time.³

The symptoms include:³

• Blurry vision
• Light sensitivity
• Glare and halos around lights
• Faded or yellowed colors
• Difficulty seeing at night

Cataract symptoms typically progress slowly and begin to interfere with reading or driving, and other daily activities.³ If not treated, they can possibly lead to reversible vision loss.

How Cataract Surgery Works

Cataract surgery is an outpatient procedure that replaces the cloudy natural lens with a clear artificial one. Your eye is numbed with drops or a small injection, and you get anesthesia to help you relax. You’ll be comfortable but arousable, and may notice light and movement, but you won’t feel any pain.⁴

Using a microscope, the surgeon makes tiny openings near the cornea, breaks up the cloudy lens with ultrasound, and removes it. A new IOL is then placed inside the same thin capsule that holds your natural lens. That capsule stays in place to support the new lens, and can sometimes become cloudy later.⁴

What is a Secondary Cataract?

A secondary cataract, or posterior capsular opacification (PCO), is not a true cataract. PCO happens when lens epithelial cells left behind during surgery grow and spread across the capsule.² Over time, this can lead to scar tissue on the posterior capsular membrane, causing cloudy vision or other visual disturbances.⁴

How is PCO Different from Initial Cataracts?

• Location: Natural cataracts affect your eye’s natural lens, and PCO affects the capsule that holds the artificial lens after surgery.⁴
• Cause: Cataracts result from protein breakdown in the natural crystalline lens, but PCO is caused by remaining epithelial cells after surgery.³
• Treatment: Cataract treatment requires lens removal and replacement, while PCO can be treated with a simple laser procedure.⁴

This difference is important to understand. PCO doesn’t mean your surgery failed, only that the capsule behind your new lens has become cloudy.

Causes and Risk Factors

Anyone can develop PCO, but some people are more prone than others.

After cataract surgery, small epithelial cells may remain in the lens capsule. Over time, these cells multiply and create scar tissue on the posterior capsule membrane, leading to clouding of the lens capsule.^1,4

Several things can increase your chances of developing posterior capsular opacity:^1,2

• Age: Younger patients often experience faster cell regrowth.
• Other eye conditions: Myotonic dystrophy, diabetic retinopathy, uveitis, and retinitis pigmentosa can increase risk.
• Lens material and design: Some synthetic materials and lens edge designs reduce the chance of epithelial cell growth.

Symptoms of PCO

PCO can cause confusion for patients because they share many of the same symptoms as primary cataracts.

Symptoms of PCO include:^1,2

• Blurry or cloudy vision
• Glare and halos around lights
• Double vision or decreased contrast sensitivity
• Colors that seem faded

Just like your original true cataracts, these symptoms can interfere with daily activities, including reading, computer work, and night driving. Patients sometimes feel as though their cataract has “come back,” but it’s actually the capsule behind the new lens that’s become cloudy.

Treatment for Secondary Cataracts

The good news is that PCO is highly treatable. Most cases are corrected with a quick and painless outpatient procedure called a YAG laser capsulotomy.¹

Your eye doctor can diagnose posterior capsule opacification with a slit-lamp exam. If a visually significant PCO is confirmed, YAG laser capsulotomy is the standard treatment.¹

What to Expect During YAG Laser Capsulotomy

This laser-assisted procedure takes only a few minutes. Because it’s performed in an outpatient setting, you can go home the same day.¹

Here’s what to expect:¹

1. The eye is numbed with anesthetic drops.
2. The pupil is dilated with dilating drops.
3. A YAG laser creates a small opening in the cloudy posterior capsule.
4. The opening allows light to pass through the IOL and restores clear vision.

If you’re like most patients, your vision will be noticeably sharper within hours after YAG laser capsulotomy. You may have mild irritation or see floaters appear temporarily after the procedure, but these usually resolve quickly.¹ Your doctor may prescribe medicinal eye drops for you, which will reduce inflammation and support healing.⁵

To help your eyes feel more comfortable as you recover, use soothing CorneaCare warm compresses or gentle CorneaCare eyelid wipes if you experience mild dryness. 

If you have dry eye syndrome, your ophthalmologist or optometrist may recommend lubricating eye drops. A good choice is CorneaCare preservative-free artificial tears.

Can Cataracts Come Back? FAQ

Putting It All Together

Cataracts don’t come back once they’re removed, but posterior capsule opacification (PCO) can cause similar cloudy vision down the road. The condition is common, affecting up to half of patients within several years after surgery, but it’s easily treated with a quick laser procedure on an outpatient basis. 

With modern lens technology, skilled surgeons, and patient-centered care, most people achieve excellent long-term results. If you notice cloudy or blurry vision after cataract surgery, reach out to your eye care provider for evaluation and vision restoration.

What’s Next

Cataracts can be a normal part of aging, and we recommend reading these articles next:

• How Long Between Cataract Surgery on Each Eye
• How to Prevent Cataracts (Are Cataracts Preventable?)
• What is the Average Age for Cataracts?