YAG Laser Capsulotomy

What is posterior capsular opacification?

The natural lens lives inside a bag called the capsule. With your original cataract surgery, the front of the capsule is opened and the natural lens is removed, but a thin membrane called the posterior capsule is left behind to help hold the implanted artificial lens in position. However, in up to 33% of patients after their cataract surgery, the posterior capsule can become cloudy over time. This process is called posterior capsular opacification. It is caused by a proliferation of cells that cause scarring, changes and wrinkling of the posterior capsule. This scarring is a normal healing response. This in turn causes cloudy vision, glare, and other symptoms that interfere with normal vision. It can occur months or years after the original surgery.

What is a YAG laser posterior capsulotomy?

It is a non-invasive laser procedure to remove the cloudiness or glare that interferes with a patient’s vision after their cataract surgery. The procedure is performed in an outpatient clinic and is quick, painless and effective. It is usually only performed once on an affected eye and it is exceedingly uncommon to need a second laser treatment on the same eye.

What to expect on the day of your procedure

Once you have been booked in by the receptionist, drops will be used to numb your eye and dilate your pupil. No injections or needles are used.

Your ophthalmologist will use a YAG laser to create an opening in the centre of the cloudy posterior capsule. The opening allows clear passage of light rays and removes the obstruction that was interfering with your vision.

The actual procedure only takes 1-2 minutes. The results are almost immediate, however your vision may be a little blurry from the drops and the dilation, so someone will need to drive you home. You will be asked to use anti-inflammatory drops for one week after your treatment. You will be contacted for a follow-up appointment which will be scheduled about 4 weeks after the laser treatment.

Realistic expectations

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 risk is a rise in pressure within the eye. There is also a slightly higher risk of retinal detachment and swelling of the macula both of which are quite rare after the laser treatment.
You may experience some floaters after the laser and most of these will resolve within a few weeks to months.