In brief: Secondary cataract is an opacification of the posterior lens capsule after cataract surgery, not a recurrence of the disease – the artificial lens remains transparent. It is treated with YAG laser capsulotomy: no incision, with anesthetic drops, the procedure takes 2–5 minutes, and vision improves within a few hours to several days. Price: PLN 800 per eye, Warsaw and Krakow.
Secondary Cataract – YAG Laser Capsulotomy in Warsaw and Krakow
In brief: Secondary cataract is an opacification of the posterior lens capsule, not a recurrence of cataract. It affects approximately 20% of patients within 2–5 years after cataract surgery. It is treated with YAG laser capsulotomy — without incision, with topical anesthesia, in 2–5 minutes. The procedure is performed once; the capsule does not opacify again. Price: PLN 800 per eye in Warsaw and Krakow. Follow-up the next day, mandatory visit after one month.
What is secondary cataract?
During cataract surgery, the surgeon removes the clouded lens but preserves its thin, transparent capsule — this is where the implant is placed. In some patients, the posterior wall of this capsule gradually opacifies over time and scatters light before it reaches the retina. This phenomenon is commonly referred to as secondary cataract; in medical terminology, it is posterior capsule opacification (PCO).
The natural lens has been permanently removed and cannot opacify a second time. Therefore, secondary cataract is not a recurrence of the disease or a result of an error during surgery. See also: cataract — symptoms, diagnosis, and treatment.
Why does it appear after cataract surgery?
Single lens epithelial cells remain on the inner surface of the capsule. Over time, they can proliferate and migrate to the posterior wall of the capsule, forming a layer that impairs transparency. This is a natural healing reaction, not a complication of the procedure.
The risk depends, among other things, on the patient’s age, co-existing diseases, and the material and design of the implanted lens. Latest generation lenses with a sharp posterior edge significantly reduce this risk.
What are the symptoms of secondary cataract?
Symptoms resemble those experienced before cataract surgery and gradually worsen:
- gradual blurring of vision, despite earlier improvement after surgery
- glare and halo effect around lights, especially at night
- weakened contrast vision and a sensation of a “dirty window”
- difficulty reading in dim light
Symptoms may appear from several months to several years after surgery. If vision begins to deteriorate after cataract surgery, it is advisable to undergo an examination — diagnosis takes only a few minutes.
What does YAG laser capsulotomy involve?
The Nd:YAG laser creates a small opening in the opacified posterior capsule, precisely along the visual axis. Light can once again reach the retina freely. The procedure is performed without incision, without sutures, and without opening the eyeball — the laser works through the cornea.
The implant remains in place and is not replaced.
How long does the procedure take and what is the process?
- Preparation: pupil-dilating drops, take about 30 minutes to work
- Anesthesia: topical drops, no injections
- Procedure: 2–5 minutes per eye, patient sits at a slit lamp
- After the procedure: intraocular pressure check
- Total time at the clinic: approximately 2 hours
During the procedure, the patient sees flashes of light and feels slight pressure from the contact lens applied to the cornea. The procedure is not painful.
What does recovery look like?
Vision improvement is usually felt within a few hours, once pupil dilation subsides. Full stabilization occurs within a few days. For the first few weeks, some patients may see small floaters — these are capsule fragments floating in the vitreous humor, which become unnoticeable over time.
Drops after the procedure
- Antibiotic and steroid — for 1 week
- Non-steroidal anti-inflammatory drug (NSAID) — for approximately 4 weeks
The prolonged use of NSAIDs is a conscious element of our protocol: it reduces the risk of macular edema, the most common complication affecting visual acuity after intraocular procedures.
Follow-up visits
- The next day — post-procedure check-up
- After one week — if necessary, depending on the eye’s condition
- After one month — mandatory check-up
In addition, intraocular pressure is checked immediately after the procedure, while still at the clinic.
Return to daily activities
- Driving: not permitted on the day of the procedure. For some patients, it may be possible the next day — always with the ophthalmologist’s approval during the follow-up visit
- Office work: we recommend 4–7 days of rest; the final date depends on the eye’s condition
- Accompanying person: please arrange for one on the day of the procedure — the pupil remains dilated for several hours
More about returning to form after eye procedures: recovery after cataract surgery.
Contraindications and possible complications
YAG capsulotomy is a procedure with a high safety profile, but like any medical procedure, it has its limitations. Qualification is determined by examination.
Possible side effects: transient increase in intraocular pressure in the first few hours, floaters in the field of vision, transient inflammation. Rarely: macular edema, damage to the implant surface, retinal detachment.
Contraindications: active eye inflammation, corneal opacities preventing laser focusing, inability to maintain a stable position during the procedure.
How much does YAG capsulotomy cost?
PLN 800 per eye — this price applies in Warsaw and Krakow. A full breakdown can be found in the cataract treatment price list.
Where do we perform the procedure?
We perform YAG laser capsulotomy at both SwissLaser clinics. The procedure is carried out by our ophthalmologists.
- Warsaw — ul. Kolejowa 1. Cataract surgery in Warsaw
- Krakow — ul. Kluczborska 15. Cataract treatment in Krakow
Schedule a qualification examination — assessment of the posterior capsule takes a few minutes.
Sources
- Awasthi N, Guo S, Wagner BJ. Posterior capsular opacification: a problem reduced but not yet eradicated. Arch Ophthalmol 2009;127(4):555–562. doi:10.1001/archophthalmol.2009.3
- Karahan E, Er D, Kaynak S. An overview of Nd:YAG laser capsulotomy. Med Hypothesis Discov Innov Ophthalmol 2014;3(2):45–50. PMC4181199
- Miller KM, Oetting TA, Tweeten JP et al. Cataract in the Adult Eye Preferred Practice Pattern. Ophthalmology 2022;129(1):P1–P126. doi:10.1016/j.ophtha.2021.10.006
Content substantively verified by Dr. med. univ. (Vienna) Victor Derhartunian, FEBO, FWCRS – specialist in refractive and corneal surgery, chief surgeon at SwissLaser (Warsaw, Krakow) and EyeLaser (Vienna, Zurich). Last verification: October 2, 2026.
Frequently Asked Questions about Secondary Cataract
Is secondary cataract a recurrence of cataract?
No. The natural lens has been permanently removed and cannot opacify again. The posterior capsule, where the implant is placed, becomes cloudy — therefore, the correct term is posterior capsule opacification.
Does the procedure hurt?
No. YAG capsulotomy is performed under topical anesthesia, without incision. The patient only feels flashes of light and slight pressure from the contact lens applied to the eye.
How long does laser capsulotomy take?
The procedure itself usually takes 2–5 minutes per eye. Including pupil dilation and post-procedure pressure check, you should plan for approximately 2 hours at the clinic.
When will sharp vision return?
Improvement is usually felt within a few hours, after pupil dilation subsides. Full stabilization occurs within a few days.
Does the procedure need to be repeated?
No. The opening in the capsule remains permanent, and the capsule does not opacify again. Capsulotomy is performed once per eye.
Can I drive after the procedure?
Not on the day of the procedure — the pupil remains dilated for several hours, so we ask for an accompanying person. For some patients, driving may be possible the next day, always with the ophthalmologist’s approval during the follow-up visit.
When can I return to work?
For office work, we recommend 4–7 days of rest; the final date depends on the eye’s condition and is determined at the follow-up check the next day.
What drops are used after capsulotomy?
An antibiotic and steroid for one week, and a non-steroidal anti-inflammatory drug for approximately 4 weeks. Prolonged use of NSAIDs reduces the risk of macular edema.
How many follow-up visits are needed?
A check-up the next day, if necessary after one week, and mandatory after one month. Additionally, intraocular pressure is checked immediately after the procedure, while still at the clinic.
How much does YAG capsulotomy cost at SwissLaser?
PLN 800 per eye, in Warsaw and Krakow.
