Floaters: these are harmless clumps of cells which move around inside the vitreous (a jellylike substance which fills the inside of the eye). You may see floaters as dots, circles, lines, clouds or cobwebs. It is normal for the procedure to cause floaters, but these normally move out of the line of sight in the days to weeks after the procedure; only rarely are they a persistent problem.For some people laser treatment for PCO can cause eye pressure to briefly rise. If your clinician is concerned about this, they will check your eye pressure soon after the laser treatment. If your eye pressure has increased, you will be provided with some eye drops or a tablet to bring it back down.Inflammation inside the eye: this is uncommon and responds rapidly to anti-inflammatory drops.Minor damage to the intraocular lens: minor scratches are occasionally unavoidable – largely due to patient movement during the procedure – but very rarely cause visual problems.

YAG LASER CAPSULOTOMY

Why would I need YAG laser capsulotomy?

Posterior capsular opacification (PCO) is a relatively common occurrence after cataract surgery, a condition which is diagnosed by your optometrist at a routine eye test, and is easily treatable.

With modern intraocular lenses, about 1:10 people develop a thickening of the back (posterior) of the lens capsule which holds your artificial lens in place. Thickening of the capsule means that light is less able to travel through to the retina (the light sensitive layer at the back of your eye). Sight can become cloudy or blurred, or you may have problems with bright lights and glare. This process can come on quickly, however, in most cases it develops months to years after the procedure.

If you develop PCO, you may need to have laser treatment to make your vision clear again. This type of laser is safe and has very few complications. The procedure is done by making a gap in part of the back of your lens capsule using the YAG laser, so that the light can once again pass directly to the retina. For the vast majority of people, this leads to a huge improvement in their vision.

YAG laser treatment is an abbreviation of Nd:YAG laser treatment, which stands for Neodymium Yytrium Aluminium Garnet, the elements used in the creation of the laser beam.

What happens before YAG laser treatment?

Your vision will be checked, and then eye drops are instilled to dilate your pupil; these can take up to 30 minutes to work. The retina at the back of the eye is examined to ensure that there are no other problems.

The benefits as well as possible complications of the treatment will be discussed with you prior to you signing the consent form. The procedure only takes about five to ten minutes, but due to the various tests needed please expect to be at the clinic for up to an hour.

How is the YAG laser treatment carried out?

The laser treatment is painless and is carried out while sitting at a machine similar to the one you were examined with in the clinic.

In most cases, there is no need for the laser operator to touch your eye at all, but in rare cases local anaesthetic drops will be given and a special contact lens may be placed on your eye to steady it and help focus the laser beam. The treating YAG laser light is invisible, but a bright light is used so that the capsule can be seen; you may also see a red aiming beam moving around, but this has no lasting effect on the eye. Each laser shot lasts a fraction of a second and you will hear a loud clicking sound at the same time.

What happens after YAG laser treatment?

The laser cuts a hole in the opaque membrane behind the implant. This allows light to reach the retina, therefore bringing vision back to the level it was before the membrane became cloudy.

It may take several days before your vision is fully restored. Drops may be given for you to use after the procedure.

We advise that you do not drive yourself home after your procedure as it can take some time for the drops that dilate your pupils to wear off, and your vision may still be blurry following the laser. Please ensure that you make other travel arrangements. As a result of the laser treatment not requiring any incisions or stitches, you are normally able to return to your daily activities straight away.

What are the risks of YAG laser treatment?

The laser procedure is considered very safe. Though there are some risks, serious side effects are very rare. If a contact lens is used, your eye may be a little sore following the treatment, but this should soon wear off.

Common complications

Floaters: these are harmless clumps of cells which move around inside the vitreous (a jellylike substance which fills the inside of the eye). You may see floaters as dots, circles, lines, clouds or cobwebs. It is normal for the procedure to cause floaters, but these normally move out of the line of sight in the days to weeks after the procedure; only rarely are they a persistent problem.
For some people laser treatment for PCO can cause eye pressure to briefly rise. If your clinician is concerned about this, they will check your eye pressure soon after the laser treatment. If your eye pressure has increased, you will be provided with some eye drops or a tablet to bring it back down.
Inflammation inside the eye: this is uncommon and responds rapidly to anti-inflammatory drops.
Minor damage to the intraocular lens: minor scratches are occasionally unavoidable – largely due to patient movement during the procedure – but very rarely cause visual problems.

Rare but serious complications

Retinal damage: having had cataract surgery already, your risk of retinal detachment is slightly higher than the general population and YAG laser treatment does not change this. Exceptionally rarely, patients can develop a retinal detachment after laser treatment, which can happen days, weeks or months later; whether this is a result of the laser, or the previous cataract surgery, is difficult to decide. Such a complication is more likely to occur if you were very shortsighted before your cataract surgery. If you have any concerns, the clinician performing the procedure will discuss this with you and will also describe the symptoms of retinal detachment. Please also be aware that retinal detachment surgery is normally very successful in preserving or restoring good vision.
Rarely, treatment can cause some swelling of the retina, cystoid macular oedema. This is usually treatable with simple eye drops and resolves over a few weeks.