YAG Laser Capsulotomy

Lasers are not routinely used to remove cataracts. Cataract surgery is best performed using ultrasonic sound waves, not laser light. For more information see our section on Cataract Surgery.

Introduction

A special laser, called a Nd:YAG (yttrium-aluminum-garnet) laser is used for the removal of capsular haze, sometimes referred to as a secondary cataract.

View Video

Capsular haze is a thin film of scar tissue that occasionally forms on the posterior capsule behind the intraocular lens (IOL) implant. With modern intraocular lens implant designs and materials, the incidence of capsule haze has fallen to very low levels.

Capsular haze is painless and occurs only in patients who have undergone cataract surgery, causing the vision to temporarily be blurred again. Patients sometimes think their cataract has grown back, but it hasn’t. Once a cataract has been removed, it will not reoccur.

How it works

The posterior capsule is a thin membrane in the eye that holds the natural lens. It is left in the eye following cataract surgery. Very occasionally, the capsule thickens and becomes a little opaque, like a frosted glass window. This stops light from reaching the back of the eye, making it difficult for you to see, especially at night or in sunlight.

Capsule thickening may occur in months following your cataract operation, but more commonly it occurs two or three years later. Capsular haze does not hurt the eye in any way; it merely makes vision fuzzy.

The first signs of capsular haze are typically: increased glare with bright lights and a gradual decrease in vision. Dr. Seibel will confirm the diagnosis.

Surgical procedure

Removal of capsule haze is an outpatient minor laser procedure. It requires dilation of the eye, only takes a few minutes and is entirely painless.

1. The front of your eye is numbed with special drops and a small contact lens is placed on your eye. You place your head on the frame of a YAG laser machine (as seen in photo at the top of this page), and Dr. Seibel precisely focuses the laser on the capsule.
2. The laser makes tiny holes in the capsule, in a pattern that Dr. Seibel determines to be best for your individual condition.
3. There is no pain or chance of infection since no incision is required; you hardly notice anything at all. You will be given an anti-inflammatory eye drops following the procedure.

Recovery

Following a YAG laser capsulotomy, you may resume your normal routine immediately and may expect your vision to improve within a day following the procedure. Anticipate some floaters over the next few weeks time.

After the procedure is completed, you will be required to return in one week for a quick check of vision, pressure, and overall results.

As a precaution, you should test your sight every day following the procedure by covering the eye that did not have surgery and checking your vision in the eye that did. You should have your eyes checked each year after this treatment, for glaucoma and other problems. If you have a slightly unusual eye, these check ups are critical. For example, if an injury was the cause of your cataract, you need to have your eyes checked one month after treatment and every year thereafter.

Risks

The laser is considered especially safe with very few complications. As with any eye procedure, contact Dr. Seibel immediately if visual acuity worsens or fails to improve.

Very occasionally the laser may disturb the retina. This might not be noticeable for months or even a year or two later. If this should occur, you might notice blurring of central vision, flashes of light during the daytime, floaters beyond the normal few weeks after surgery, or a curtain drifting across your vision.

If you suddenly notice a lot of flashes and floaters, have your eye examined right away for a tear in the retina. Or, if a curtain or shutter drifts across your vision, you must see a specialist as soon as possible to check for a retinal detachment (this means going to an emergency eye care facility).