What is a Yag Capsulotomy?
During your cataract operation, the natural lens inside your eye that had become cloudy was removed. A new artificial lens was put inside the lens membrane (called the bag or capsule) in your eye. In some patients, the capsule thickens after surgery and becomes cloudy, interfering with light reaching the back of the eye. When this happens, your sight becomes hazy. Capsule thickening can happen any time in the months following your cataract operation. In a Yag laser capsulotomy, the doctor uses a special lens to apply a laser beam to the capsule. The laser then makes small holes in the capsule, often in a circle or cross. The holes then join up and, like tearing a postage stamp, a small hole is made in the capsule. This results in a more clear path for light entering the eye.
What causes posterior capsule opacification (PCO)?
Although some people call PCO a "secondary cataract", it really is not a cataract. Once a cataract is removed, it does not return. Posterior capsule opacification occurs because lens epithilial cells remaining after cataract surgery have grown on the capsule.
What happens during the procedure?
This laser is done conveniently in office and requires no prior preparation for the patient. You will have an anesthetic eye drop instilled to numb the surface of the eye. Then you will sit at a machine - similar to the one used to examine your eyes when you routinely visit the eye clinic - which has a special laser attached. The doctor may put a mirrored lens on your eye before applying the laser beam. This lens helps the doctor view the membrane clearly to be able to apply the laser and make a small hole to clear the vision. The treatment is typically painless and only takes a few minutes.
What happens after?
Following the procedure, no special treatment is required and you can go back to your normal daily activities straight away (although you may have a dilated pupil). If you have discomfort once returning home, we suggest taking Tylenol or Advil for relief. Occasionally there is mild discomfort for the remainder of the day after treatment, but it should pass. For a few days after the laser, you may notice more floaters. You may also be asked to come back after treatment to make sure your eye has settled down properly. This appointment will be given to you before you leave the office if the doctor has requested for a follow up.
Is the laser safe?
The laser is considered very safe, with very few complications. Occasionally, another treatment may be needed to release the capsule a second time. Only a small hole is needed, so the lens implant still has enough support.
Are there any risks?
Although a Yag laser capsulotomy poses slight risks, overall the procedure is extremely safe. The most significant risk - although rare - is that the retina can become detached from the inner back of the eye. Statistics suggest that the lifetime risk of a detached retina as a cataract surgery complication is about 1 percent. That number rises to about 2 percent after Yag laser capsulotomy. If however you experience a sudden increase of floaters accompanied by flashing lights and a curtain of gray moving across your field of vision, you should contact your ophthalmologist immediately or go to the nearest emergency department.
Do I need to be accompanied for my treatment?
Not necessarily. However, if dilating drops are used, they can have a blurring effect on your vision, which can in some cases last up to 8 hours. Your doctor will advise you if you will need to be dilated for this procedure.