Internal Goniotomy
Internal goniotomy is part of a group of procedures known as minimally invasive glaucoma surgery. It is particularly well suited to patients with mild to moderate glaucoma who are undergoing cataract surgery.
During cataract surgery, the cloudy natural lens is removed, but its delicate outer membrane, the capsule, is left in place to support the artificial lens implant. Over time, it is common for residual lens epithelial cells to migrate and proliferate on the back surface of this capsule.
This cell growth causes the capsule to become cloudy and wrinkled, scattering light and decreasing visual quality. The artificial lens itself remains clear; it is the supporting capsule behind it that becomes opaque.
The symptoms often mirror those of the original cataract: gradually blurred or foggy vision, increased glare from lights, reduced contrast, and difficulty with reading or night driving. Many people describe feeling as though the cataract has “come back,” even though the implanted lens is still clear.
Posterior capsule opacification is a natural response of the lens capsule to surgery and residual cells. It is not a sign that the original operation was poorly performed. Younger patients at the time of cataract surgery are more likely to develop it, and certain eye conditions may influence how quickly it appears, but almost anyone who has had cataract surgery can develop some degree of capsule opacification if they live long enough.
Diagnosis is made during a slit lamp examination. The ophthalmologist looks through the pupil to examine the capsule behind the lens implant. Characteristic folds, opacities, or pearl-like cell clusters are seen. Visual acuity is measured and compared with previous records to assess the functional impact.
You should see a specialist if your vision deteriorates after a period of good sight following cataract surgery, especially if glare, halos, or difficulty reading return. Posterior capsule opacification is easily confirmed or excluded during an examination, and if it is the cause, laser treatment can usually restore clarity promptly.
Internal goniotomy is part of a group of procedures known as minimally invasive glaucoma surgery. It is particularly well suited to patients with mild to moderate glaucoma who are undergoing cataract surgery.
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