During cataract/lens surgery the lens is removed and a thin membrane (capsule) that held the lens is left in place to hold the implanted artificial lens.
The lens capsule is important in providing stability of the prosthetic intraocular lens implant ( IOL ) and heals by “shrink-wrapping”around the lens implant. A stable lens ensures a more predictable outcome. An intact capsule also ensures more stable vision after surgery along with fewer surgical complications.
Sometimes in the process of healing, the membrane of the lens can sometimes (approx 5-10%) become cloudy and can make vision blurry if it affects the centre of the lens capsule. This is known as posterior capsule opacification or PCO for short.
Vision can be restored rapidly with a quick painless laser procedure performed in the outpatient clinic.
What to expect on the day
Once checked in by the receptionist you will have a vision test and the pressure within your eyes will be checked. The procedure will be explained once again to you and you will be asked to sign a consent form. Drops will be used to dilate your pupil and later anaesthetic drops will be used to numb your eye. There are no injections or needles are used. When your eye is completely numb, a contact lens will be placed to help focus the laser accurately and also keep you from blinking.
Your consultant will use the YAG laser to create an opening in the centre for the cloudy capsule. The opening allows clear passage of light rays and eliminates the cloudiness interfering with your vision.
The actual procedure only takes about five minutes. You may get the sensation of a clicking in your eye or your head and this is nothing to worry about. After the procedure you may find your vision a little dark and this will gradually improve. The pressure in your eye will be checked again approximately 10-20 minutes after the procedure and if normal you will then be able to go home. No eye drops are required after the operation.
Some patients notice floaters for a few days and these eventually decrease in terms of perception. Both eyes can also be treated on the same day.
The results are almost immediate, however your vision will probably be a little blurry from the drops and the dilation, so someone will need to drive you home. You will be given a follow-up appointment or a phone call will be arranged for 6-8 weeks.
Are there any risks to Yag Capsulotomy?
Serious complications with posterior capsulotomy are extremely rare. It is a safe and effective procedure, but like any medical procedure, it does have some risks. The most common being the rise in pressure within the eye. If this occurs then you may be given drops, or a combination of tablets and drops, to reduce the pressure. There is also a slightly higher risk of retinal detachment and also swelling of the macula both of which are rare if the laser treatment takes place more than 6 months following original cataract/lens surgery..
If your eye surgeon recommends the procedure, you will be shown videos and be provided with information to help you make an informed decision. Please do not hesitate to ask any questions.