YAG Laser Capsulotomy

What is YAG Laser Capsulotomy?

YAG Laser Capsulotomy, also known as laser capsulotomy, is a simple procedure you may sometimes need after cataract surgery. In some patients, a defect called ‘Secondary Cataract’ or ‘Posterior Capsular Opacity’ may occur.

When this defect occurs, vision can get fuzzy because a membrane in your eye called the posterior capsule might get cloudy.YAG Laser Capsulotomy helps you see clearly if your vision becomes blurry again months or years after cataract surgery.

How does the vision worsen months or years after cataract surgery?

The eye's natural lens is enclosed in a membranous bag-like structure called the lens capsule.

The membranous covering at the front of the natural lens is called the anterior capsule, and the membranous covering at the back of the natural lens is called the posterior capsule.

The front of the lens capsule is opened during cataract surgery. The cloudy lens inside the capsule is removed. In most cases, the posterior capsule is left intact, and a plastic lens implant is placed in front of it. This capsule usually is clear like a glass window.

In some patients, the posterior capsule thickens and becomes a little opaque as the residual cells of the natural lens multiply and grow on the posterior capsule. This prevents light from reaching the back of the eye.

If this happens, you may notice a gradual decrease in your vision, problems with bright light, and things might look slightly hazy. The capsular thickening does not damage the eye in any way but only makes the vision a little fuzzy. Capsular thickening can occur any time after your cataract surgery, from months to years.

How does YAG Laser Capsulotomy treat posterior capsular opacity?

Laser capsulotomy produces an opening in the thickened posterior capsule. This allows light to pass through the lens implant to the back of the eye, making vision clearer, thus treating the posterior capsular opacity.

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What to expect during YAG Laser Capsulotomy?

Before the procedure

The procedure is carried out in a specially equipped laser room. There is no need for a special surgical setup. The procedure is carried out on an outpatient basis.

First, the nurse will check your near and distance vision. So, you must bring your glasses with you if you have been using them.

After you are comfortably settled, your eye will be numbed with an eye drop. After a few minutes, your doctor will then apply another eye drop to dilate your pupil.

A contact lens will then be placed on your eye to focus the laser beam on the target (posterior capsule). The contact lens will also help keep your eyelids separated so that you will not blink. Also, it prevents small movements of your eye. A gel-like substance will be placed on the surface of your eye to protect them.

During the procedure

During the procedure, you will be asked to place your chin on the frame of the laser machine, which has a chin rest and handles for you to hold on to. The ophthalmologist will use a bright light to illuminate your eyes.

Next, you will hear a clicking noise, which is the noise of a laser machine being fired. You will not feel any pain but just some vibrations.

The laser makes small holes in the posterior capsule. The small holes join to form an opening in the capsule.

You must keep your eyes and head still during the treatment. However, should you need to move your head or eye, you should inform the doctor first.

The procedure will take just minutes to complete. But, you will need some time to prepare for the procedure, and you will also need time for aftercare. So, you can expect to be in the eye clinic for about 2 hours.

After the procedure

After the procedure, your vision will appear temporarily obscured due to the bright light released from the laser machine. Usually, normal vision will begin to return after 5 to 10 minutes in a series of colors but will remain blurred for 4 to 6 hours due to the effect of dilating eye drops.

How fast does the YAG laser capsulotomy work?

When the dilating effect of eye drop wears off after 4 to 6 hours, you will notice remarkable clarity in your vision due to the removal of opacity in the posterior capsule.

Suitable candidates for YAG laser capsulotomy

Suitable candidates are those who:

Had cataract-removal surgery and is now experiencing blurry vision again.
Are in overall good health, as with any surgery.

If you had successful cataract surgery without any complications and are now experiencing blurred vision, you will be considered a good candidate for YAG laser capsulotomy.

Some conditions that might affect your eligibility for the procedure include:

History of retinal detachment
Elevated eye pressure
Active inflammation of the eye.

Contraindications for YAG laser capsulotomy

Contraindications for YAG laser capsulotomy include opacity or scarring of the clear part of the eye (cornea), swelling or irregularity of the surface of the cornea, red eyes, and patients who are unable to hold still.

Side effects of YAG Laser Capsulotomy

Serious complications or side effects following laser capsulotomy are rare. However, you may notice ‘floaters’ which are black spots or lines which move around in your field of vision. These are due to membrane breaking up following treatment, and usually improve with time.

There may be a temporary increase in eye pressure for which you will be prescribed eye drops. There may also be blurring of vision due to fluid accumulation in the eye’s light-sensitive layer (retina), which may require treatment with some oral medications.

Self-care after laser capsulotomy

After the procedure, there are some steps that you should follow as part of post-procedure self-care. These include the following:

Avoid exposure to bright light for 24 hours.
Avoid spending time with gadgets like mobile phones or laptops for at least 24 hours.
Take medications strictly as prescribed.
Do not drive for at least 24 hours.
Do not perform heavy physical exercises for at least three weeks.
Do not miss a follow-up appointment with your eye doctor.

If you experience difficulties despite sticking to your medications, you should immediately contact your doctor and schedule an appointment as soon as possible.

How is laser capsulotomy different from other treatments?

Initially, surgical capsulotomy was performed for the treatment of posterior capsular opacity. However, surgical capsulotomy cannot be performed on an outpatient basis and requires a well-equipped surgical setup. Unlike surgical capsulotomy, laser capsulotomy is a relatively simple procedure that can be easily carried out on an outpatient basis and does not require a special surgical setting.

The time required for laser capsulotomy is relatively short compared to surgical capsulotomy.

Also, there are minimal risks associated with the laser procedure in comparison to surgical capsulotomy.

Laser capsulotomy has become the first-line procedure for treating posterior capsular opacity. It is deemed superior to all other medical and surgical treatments because of its high efficacy, safety, and simplicity.

FAQ

How do I know that I need YAG laser capsulotomy?

If you had successful cataract surgery without any complications and are now experiencing blurred vision, you may need a YAG laser capsulotomy to have a clearer vision.

Why do I need YAG Laser capsulotomy?

After cataract surgery, an uncommon defect called posterior capsular opacity may occur. In this condition, the posterior capsule may become thickened and opaque. To remove this opacity, you will need YAG Laser Capsulotomy.

How long does the procedure of YAG Laser Capsulotomy take?

YAG laser capsulotomy is a relatively simple procedure performed on an outpatient basis. It takes around 10 minutes for the procedure to complete. But, you may need to come early to prepare for the procedure and for aftercare. Overall, you can expect to be at your eye doctor’s office for approximately 2 hours for the procedure.

How does YAG Laser Capsulotomy work?

YAG Laser Capsulotomy is used to treat opacity in the posterior capsule (membranous covering present at the back of the lens) following cataract surgery. The procedure creates small holes in the posterior capsule, which join up and form an opening. After this, light can pass through the implanted lens to the back of the eye, thus leading to clarity in vision.

How will I be prepared for YAG Laser Capsulotomy?

Your eye doctor will apply a drop in your eye to numb it. After a few minutes, he will apply another drop to make your pupil dilated. Next, he will apply a special contact lens over your eye to focus the laser light on the posterior capsule. To ensure that the contact lens does not scratch your eye, a jelly will be placed on the surface of your eye.

What can I expect during the procedure?

To carry out YAG capsulotomy, you will be asked to place your chin in the frame of the laser machine, which has a chin rest and handles to hold on to. There is a bright light shining into your eye and you will hear a clicking noise, which is the noise of a laser machine being fired. You will not feel any pain.

What can I expect after the procedure?

After the laser treatment, your eyes will be temporarily ‘blind’ and ‘dazzled’ by the bright light emitted from the laser machine. Your vision will gradually return over 5 to 10 minutes in a series of colors but will remain blurry for 4 to 6 hours until the dilating effect of the eye drop wears off. You can resume work 24 hours after the procedure.

Will Laser Capsulotomy improve my vision?

Yes, if you are suffering from blurred vision even after cataract surgery, laser capsulotomy can improve your vision. In some rare cases, you may not experience improvement in your vision if you have other age-related changes in your eye.

What should I do after a laser capsulotomy?

You will be given some prescription eye drops and medications to use after the treatment. You must use these drops and medications as adviced by your doctor. You should not miss a follow-up appointment with your doctor.

Can I drive after YAG laser capsulotomy?

No, this is because dilating eye drops are used to open up pupils, which may result in blurred vision for hours following the treatment. Therefore, it is best to make alternative arrangements. Driving can be usually be resumed 24 hours after the procedure.

Can I watch TV after YAG laser capsulotomy?

You should avoid watching TV for at least 24 hours following the procedure. To improve chances of rapid recovery from the procedure, you should avoid all forms of screen, i.e., mobile phones, laptops, and TV for 24 hours.

Can I exercise after YAG Laser Capsulotomy?

As a general precaution, heavy exercises and lifting should not be done for at least three weeks. Other light exercises can be resumed 72 hours after the procedure.

What are the side effects of YAG laser capsulotomy?

Serious complications following this procedure are rare. There may be a temporary rise in eye pressure, detachment of the retina, pitting or scratching of implant lens, and exacerbation of infection, if any. You may also see floaters, which are black spots and lines that move around in your visual field.

How long do ‘floaters’ last after YAG laser capsulotomy?

For most patients, seeing floaters (black spots and lines that move around in the visual field) after YAG laser capsulotomy is common. They should decrease after a few weeks while you continue recovering from the procedure.

What happens if YAG Laser capsulotomy does not work?

There is a small chance that there will be no improvement in your vision following YAG Laser Capsulotomy. If your vision does not improve, you will need further eye assessment as the cause of continued visual defect may be other age-related changes in the retina.

Call us today to see how we can make your vision sharper and clearer.

At Focus Eye Care & Surgery, our New York refractive surgeon will make a thorough eye evaluation to get the correct diagnosis. The result is a treatment plan developed with you so your vision and lifestyle need are addressed.