What is YAG capsulotomy?

Following your cataract operation, the clear sac (capsule) into which your new artificial lens was implanted may have gone cloudy (posterior capsule opacification or PCO). This makes it difficult to see clearly, as if you’re looking through frosted glass. Apart from affecting your vision, the thickening does not damage the eye in any way. YAG Capsulotomy is the laser treatment that creates a hole in the centre of the thickened lens capsule, and so allows light to enter the eye more readily, restoring clear vision, providing that the rest of the eye is healthy.

Have my cataracts come back?

If your vision was bright soon after surgery, but has become increasingly misty over a period of time, it does not mean that your cataracts have come back.

It could be that a membrane behind the implanted lens has become thicker and cloudy. This is called posterior capsular opacification (PCO). This happens fairly often and is something that can be easily treated.

What does treatment involve?

The YAG Capsulotomy provides a permanent solution for PCO and you will only need ONE treatment for each eye as the condition cannot return.

What are the alternative treatments?

Remember you do not have to receive laser treatment if you do not want to. However, there are no known alternative treatments to YAG Laser Capsulotomy at the present time.

What are the benefits and risks of YAG capsulotomy?

The most obvious benefit of having YAG laser capsulotomy is to restore your vision to how it was after your cataract operation.

However, you should be aware of a very small risk of complications after the treatment.

What complications can happen after treatment?

Occasionally the opening made by the laser beam is incomplete, or not big enough. This will be discovered either after your treatment, or on your follow-up visit. If this is the case, it will be necessary to repeat the treatment at a later date.

Generally it is a safe and straight forward procedure and complications are very uncommon but can include:

  • Raised pressure within the eye
  • Floaters (fragments of lens capsule) may appear across the vision. These usually become less noticeable with time
  • Flashes of light in the eye
  • Swelling in the retina causing blurring; This usually improves with time
  • On rare occasions, the eye may develop inflammation, or become red and painful
  • In very rare cases, there is a risk of a detached retina, especially if you are near sighted or if the lens implant is dislocated. This would require further treatment
  • You may also get a minor headache due to the bright lights used during treatment. In this case, we would advise your normal treatment for a headache.
  • Small risk of vision becoming worse.

Although complications from this treatment are uncommon, the chance of any problems occurring depends on the overall health of your eye and other factors, such as your general health.

What happens during the laser treatment?

Please do not drive yourself to the hospital. You will need to travel by public transport or arrange for someone else to take you home after your appointment. You should not drive or operate machinery for the rest of the day.

This is an outpatient treatment will be performed in one of our laser treatment rooms as a ‘walk in – walk out’ procedure that takes about 10 minutes but you are likely to be in clinic for 1-2 hours.

Special preparations such as fasting or changing into operating theatre clothes are not necessary, and you should continue to take your regular medication and diet as usual.

The pre-operative assessment appointment can take place on the day of treatment.

This will include the following steps:

  • Visual acuity measurement – measure your eyesight using a letters chart
  • Eye drops – to dilate or enlarge your pupils. This can take up to 20 minutes to work and an  anaesthetic eye drop to numb the surface of the eye.

The procedure

You will be asked to sit in a chair in front of the laser machine with your chin on a rest to help steady you. A special contact lens will be placed on the eye to keep it open and direct the laser beam during the short treatment.

You may see a series of bright lights and hear a clicking noise while the treatment is being carried out, but don’t worry it is painless.

It is very important that you stay as still as you can during the treatment to avoid damage to other parts of the eye.

What happens after the treatment?

You are free to go home after your treatment. Your vision will be temporarily misty after the treatment but should improve over the next few hours.

Anti-inflammatory drops will be prescribed after the laser treatment for one week. These help to minimise inflammation (not infection) within the eye. You do not need antibiotics, as there is no open wound on your eye.

Following the procedure, no special treatment is required, and you can go back to your normal daily activities straight away. If you have discomfort once you have returned home, we suggest that you take your usual pain reliever following the instructions on the pack. It is normal to have itchy, gritty or sticky eyes and mild discomfort for the remainder of the day after the treatment.

You will be asked to come for a review a few weeks after the laser treatment to make sure your eye has settled down properly. This appointment will be given to you before you leave the hospital.