Is YAG laser capsulotomy as safe and simple as they say?

If your vision is getting blurry after having undergone cataract surgery, you might have POC (posterior capsule opacification) and need further treatment. Having another eye procedure might sound daunting but YAG laser capsulotomy is a quick and painless way to get your vision back to normal.

Mr Colin Vize is an ophthalmologist with specialist expertise in performing YAG laser. In this article, he clarifies how quick and simple the procedure is and answers several key questions that patients have along their treatment journey.

What is YAG laser capsulotomy?

YAG laser capsulotomy is a clinical procedure that’s used to treat patients who have had prior cataract surgery and developed misty vision. Around 1 in 5 people who have cataracts develop an eye condition called PCO (posterior capsule opacification).

What causes POC (posterior capsule opacification)?

Only people who have undergone cataract surgery can develop POC (posterior capsule opacification). When we (ophthalmologists) perform cataract surgery, there are often microscopic deposits of the original cataract that can proliferate or grow into the capsule behind the lens. Therefore, their vision may deteriorate six months to a year after surgery.

We remove the cataract-affected lens during surgery but we leave the capsule that was behind it to support the new intraocular lens. In some people, that capsule becomes cloudy post-cataract surgery. If PCO were to affect you it would most likely occur over a year after cataract surgery.

Who treats posterior capsule opacification?

An ophthalmologist (an eye surgeon) is the specialist who would perform YAG laser capsulotomy to treat your POC. An optician is the one to diagnose PCO in many cases and will refer patients to an ophthalmologist to treat it.

When is YAG laser capsulotomy definitely needed?

If you have any symptoms of POC, which is essentially having difficulty with daily living (e.g. reading watching TV, driving), that would be an indication that YAG laser capsulotomy needs to be performed. People with POC often complain of seeing glare from lights at night, particularly while driving.

How should patients prepare for a YAG laser capsulotomy?

The only preparation patients need for YAG laser capsulotomy is to make sure they don’t drive to the clinic on the day of the procedure. This is because patients receive dilating drops in the POC-affected eye, meaning they may struggle to drive home. It would be sensible to arrange transport.

How long does YAG laser capsulotomy take?

In the preparatory phase, we put the dilating drops into the eye(s) and wait about 30 minutes for it to work. Then, the procedure takes only 10 minutes.

How soon can I have YAG laser capsulotomy after being diagnosed?

In most cases, PCO is diagnosed by an optician and a GP will rarely diagnose it. Once diagnosed, the patient is referred to an ophthalmologist for a YAG laser capsulotomy.

In my practice, I offer a one-stop approach. Patients are examined and have the option to undergo the procedure on the same day, 30 minutes later. As mentioned before, the procedure will only take 10 minutes per eye. As long as they have not had an adverse reaction to the drops, it’s fine to go ahead with the laser treatment. Generally, patients can go home as soon as the procedure is finished.

Is the YAG laser capsulotomy painful?

We will put numbing drops in the eye and then apply a lens over the eye to focus the laser beam. When the laser is triggered, patients may feel a gentle popping sensation in the eye but they should not feel any discomfort.

Are there risks of laser capsulotomy?

YAG laser capsulotomy is a very safe procedure and complications are very, very rare. Potential pitfalls of the procedure include inadvertent damage to the patient’s lens replacement (intraocular lens) or retina, but these are very rare.

How long does it take to recover from YAG laser capsulotomy?

The dilating drops will take several hours to wear off. There may be some dazzle from lights after the laser and the dilated pupils may result in blurred immediately after the procedure. However, within 24 hours it is anticipated that recovery should be complete.

What follow-ups could I expect after YAG laser capsulotomy?

Follow-ups after YAG laser capsulotomy are generally with the optician rather than the ophthalmologist. But if there are any concerns, I am freely available for consultation.

Are you in or nearby Hull and need an emergency eye appointment or planned procedure? Mr Colin Vize is available to help – find out more.