Posterior Capsule Opacification

Significant posterior capsule opacification.
  • Opacification of the posterior lens capsule following extracapsular cataract extraction.
  • Contributing factors: fibrotic changes associated with wrinkling of the posterior capsule and the formation of Elschnig's pearls (the migrating growth of residual epithelial cells towards the posterior capsule).
  • Advances in cataract surgery techniques and intraocular lens design have been shown to reduce the frequency of posterior capsule opacification.
  • Without intraocular lens implantation, the edge of the anterior capsule may adhere to the posterior capsule forming Soemmering's ring.
  • Symptoms: glare and gradual visual loss.

Management

  • Posterior capsule opacification is not routinely treated, unless when significant visual disturbances are noted.
  • If necessary, Neodynium:YAG laser posterior capsulotomy is usually performed to create a sufficient opening in the opacified posterior capsule. 
Slit lamp photograph and the retroillumination view of an opacified posterior capsule.