Can a cataract grow again? | Dr Frikkie Hartog

Can a cataract grow again

In short no, but then there is always an exception in medicine. To understand this we have to understand how exactly a cataract is removed.

The cataract is a lens inside the human eye that looks much like a magnifying glass would. It has a capsule that covers a central core of cells that become cloudy as we age. The dimensions of the cataract is approximately one centimeter across and 4mm thick. During cataract surgery a small opening of approximately 4mm is made in the front capsule of the lens and the cloudy content is removed. The consistency of the content varies significantly between patients and also depends on the age of the cataract. In order to remove the cataract through a small 2,2mm opening it has to broken down into smaller pieces that can be aspirated through a needle. Phacoemulsification is very similar to sonar energy, and very effective in breaking up the hard cataract.

It is important to note that an opening is made only in the front surface of the lens through which the content is removed. The back surface or capsule separates the gel behind the lens from the fluid that fills the space in front of the lens. It is essential that this posterior capsule is not damaged during cataract surgery. After the content is removed, a clear plastic lens is inserted into the open space previously occupied by the cataract. This lens is made of a special acrylic plastic and can be rolled up to be injected through the small 2,2mm opening through which the whole operation is performed. The plastic intra-ocular lens is thinner than the cataract it replaces and it is kept in place by two folding arms or haptics at its side that extends to keep it in place. It does take approximately one month for the lens to get fixated in its final position as the bag around it shrinks around it.


In some individuals the capsule behind the intra-ocular lens scars excessively. The clear capsule changes in color and cause haziness, and therefore the patient has the impression that his vision is again becoming blurry, as though the cataract is back. These changes are known as posterior capsule opacification or PCO for short. PCO is rare with modern cataract surgery, but can occur in anyone. Fortunately the solution is quite straightforward and quick. A YAG laser is used to painlessly break up the hazy posterior capsule. The procedure is done in the rooms with the patient sitting upright, is completely painless and only takes a minute to complete. The PCO is broken into small pieces and the patient might see a few black or gray floaters for a few days but this clears up quickly, permanently solving the haziness. The PCO can never recur.

Dr. Frikkie Hartog

Dr. Frikkie Hartog is an ophthalmic surgeon specializing in cataract and laser refractive surgery. The aim of all types of refractive surgery is to rid a patient of his spectacle or contact lens dependence. Dr Frikkie Hartog has a special interest in affording his patients the best possible results using the latest and safest technology. It is also essential to balance the increasing cost of these technologies with the financial expectation of your patients. Dr.Frikkie Hartog studied at the University of Stellenbosch and acquired his MMed Opth as well as FC Ophth degree in 2004. He has been performing cataract surgery since 2000 and laser surgery since 2005, and he has an excellent safety and success record. Frequent attendance of not only local but also overseas specialist congresses forms part of a continued learning interest. Dr. Frikkie Hartog is an avid cyclist and loves reading and spending time with his family.