The pathology of after-cataract. A minireview

After-cataract can be defined as the retropupillary, non-vitreal opacification of the lens remnants occurring after extracapsular cataract extraction (ECCE) leading to disturbance of transparency and impairment of vision. The synonymous secondary cataract is confusing, since it is also and more frequently used as cataract secondary to ocular diseases (Duke-Elder 1969). The synonymous opacification of the posterior capsule is, in fact, a misnomer, since histological observations revealed that after-cataract is not proven to be the result of changes in the remaining posterior capsule itself, but is caused by proliferation of lenticular epithelial cells, fibroblasts, macrophages and even iris-derived pigment cells on the posterior capsule (Fig. 1).