Following cataract surgery, it’s possible to experience issues with the lens membrane. It can become thickened, which may negatively affect your vision. A YAG laser capsulotomy is the one treatment option for this cataract surgery complication.

This is a noninvasive procedure with a relatively high success rate of 95 percent. It is also quick. Most people go home the same day, making it a convenient choice to restore your vision.

If you experience posterior capsule opacity following cataract surgery, this procedure should be considered. It can help to alleviate the haziness that may occur after having cataracts removed.

YAG Laser Capsulotomy

What Is YAG Laser Capsulotomy?

Following surgery to remove cataracts, there is risk of a condition referred to as posterior capsule opacification. If this occurs, YAG laser capsulotomy is the only treatment option. This issue is considered to be the most common cataract surgery complication.

When you have surgery for cataracts, your doctor removes the natural lens and replaces it with an artificial one. This eliminates the clouding that affected your natural lens. The lens capsule of your eye is where the new artificial lens goes. It remains clear after you have cataract surgery.

After surgery, the cells that are still there will grow back at the back of the capsule. They can become opaque and thickened. This reduces light’s ability to get to the retina, resulting in vision that is cloudy or blurry. Some people experience issues with glare and bright lights.

Overall, the vision problems associated with this complication are similar to those experienced when you have cataracts.

It is possible to develop this complication in both eyes if you had cataracts removed from both of your eyes. It is possible for each eye to develop the issue at different times.

This complication is common, but certain factors may increase your risk of developing it. If you have cataracts removed at a younger age, your risk of this complication is higher. It also tends to develop more in people with certain other eye issues, such as retinitis pigmentosa.

How Effective Is This Procedure?

YAG laser capsulotomy can be done quickly, and it often offers immediate improvement in your symptoms. It has a 95 percent success rate.

While there is a risk for complications because it is a surgical procedure, the overall risk is considered low. A primary risk factor is the potential for retinal detachment following the procedure. An assessment of the potential for retinal detachment five months after the operation was 0.87 percent.

It is important to find a doctor who has experience with this procedure to give yourself the lowest risk of complications and the greatest chance of success.

Results have been similar in studies on children. After a single procedure, 70 percent of the participants in one study maintained clear vision. This study also showed that complications were infrequent.

The Procedure

There is little preparation necessary for YAG laser capsulotomy. You will not have to worry about things like changing into a surgical gown or fasting.

Before using the laser, the doctor applies eyedrops to increase the size of your pupil. A separate eyedrop is given to numb the eye’s surface, so you are comfortable during the surgery.

There is a machine that you sit at for the surgery. The special laser that does the work is attached to it. Prior to using the laser beam, the doctor will put a mirrored lens on your eye. This ensures that the doctor focuses the laser properly at the right area.

Since your eyes are numb for the procedure, there is no pain. Overall, it is completed in approximately 20 minutes.

You will spend a short time in recovery, so your doctor can have your eye pressure assessed before you are released to go home.

Within about 24 hours of the procedure, your vision should start to improve. However, this may take a little longer if you have other eye conditions.

Complications with this procedure are uncommon. However, the following are possible:

  • The retina can detach, causing the appearance of floaters. If this happens, it needs to be reported immediately to your doctor.
  • The artificial lens may work its way through the opening in the posterior capsule.
  • There is a risk of eye pressure increasing.
  • Some people experience swelling in their eye. If this occurs, steroid drops are usually prescribed.

Postoperative Care

You can return to normal activities immediately following a YAG procedure; however, you may experience some vision blurriness or see floaters in your field of vision. These issues normally clear within a couple weeks.

You’ll notice an improvement in your vision within one day of the surgery. Simply make sure to follow all your surgeon’s instructions regarding aftercare. This includes applying eye drops as prescribed.

You’ll need to see your doctor for a follow-up appointment. They will assess how your eye is healing and keep an eye out or any issues.

Alternatives to YAG

If you don’t want to undergo YAG, an alternative is to simply watch and wait. Your eye doctor will monitor the progression of the condition.

In some cases, the capsule may not continue to thicken, and you can avoid further treatment. Most often, it will continue to thicken, and you will eventually need treatment.

In the short term, an updated glasses prescription can help to improve your vision.

A 2013 study found that peeling and aspiration of Elschnig pearls to be an effective alternative to YAG. Talk to your doctor about whether this would be an effective treatment for you. Most often, YAG is considered the only effective option to address the issue.

When Should I Consider YAG Laser Capsulotomy?

If you experience this complication of cataract surgery, your options are limited. Generally, you either do this surgery or do nothing.

Over time, doing nothing can lead to a worsening of your vision. It is recommended that you have YAG laser capsulotomy once your doctor diagnoses this condition and recommends the surgery.

YAG laser capsulotomy is relatively fast and simple. You get the procedure and go home the same day, in most cases. Due to the high success rate, most people who undergo this surgery report that they notice a remarkable difference in their vision almost right away.

This is generally believed to be the only procedure that can treat this issue. It is important to see an eye doctor promptly if you experience any vision issues following cataract surgery to determine if posterior capsule opacity is present.

References

The Effect of Nd:YAG Laser Treatment of Posterior Capsule Opacification on Anterior Chamber Depth and Refraction in Pseudophakic Eyes. (January 2015). Dovepress.

Posterior Capsule Opacification. (February 2009). Experimental Eye Research.

An Overview of Nd:YAG Laser Capsulotomy. (Summer 2014). Medical Hypothesis, Discovery, and Innovation Ophthalmology Journal.

The Effectiveness of Nd:YAG Laser Capsulotomy for the Treatment of Posterior Capsule Opacification in Children With Acrylic Intraocular Lenses. (April 2006). Journal of AAPOS.

What Is a Posterior Capsulotomy? (February 2019). American Academy of Ophthalmology.

Nd:YAG Laser Posterior Capsulotomy. American Academy of Ophthalmology.

PCO: What’s Wrong With Doing a YAG? (May 2018). Review of Ophthalmology.

Routine Follow-Up After YAG Laser Capsulotomy for Posterior Capsule Opacification. (March 2006). Eye.

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