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Posterior Capsular Opacity & YAG Laser Capsulotomy

The back side of the lens capsule, the clear membrane that surrounds the natural lens, remains intact at the time of cataract surgery in order to support the intraocular lens implant. Over time this membrane, known as the posterior capsule, may become thickened and hazy, causing blurred vision or glare, much as a cataract can. Posterior capsular haziness, or opacity, is sometimes referred to as a “secondary cataract,” but is not re-growth of the cataract itself. Once removed, a cataract does not return.

Development of capsular opacity varies from person to person. If significant haze develops to the point that it affects vision, a brief and painless laser procedure called YAG capsulotomy can be performed in the office to clear the opacity from the implant. The capsular opacity generally does not recur once this is performed.

The YAG Capsulotomy Procedure

YAG capsulotomy is a short, completely painless in-office procedure. Most patients are able to drive to and from their appointment alone, although the treated eye will be dilated, possibly causing blurry vision for a short time following the procedure. The actual procedure is described below:

  • The eye to be treated is dilated with topical medications (eye drops).
  • You are seated at a slit-lamp microscope, identical to the type used to examine your eyes during a regular appointment.
  • As the procedure begins, you will be asked to simply look straight ahead, or at a provided fixation target.
  • During the procedure, which generally lasts less than a minute, you will see brief flashes of light and will hear a snapping or popping noise. You will feel no discomfort at all.
  • Once the treatment is complete additional eye drops or pills may be given to control intraocular pressure.
  • During the few days following the procedure you may notice some new floaters in the treated eye- this is normal. Vision will initially be blurry but should clear by the following day.
  • You may return immediately to your normal level of activity with no restrictions.

Risks of YAG Capsulotomy

All laser procedures have some risk. Serious complications of capsulotomy are very rare and can include damage to or dislocation of the lens implant, retinal tear or detachment, or injury to other ocular structures such as the iris or cornea. Brief elevation of intraocular pressure may occur, and medication is often given at the end of the procedure to avoid problems with pressure.

If you have any questions about this or any other procedure, please feel free to contact us for more information or to schedule an appointment.