What is YAG laser capsulotomy?

The natural lens of the eye is enclosed in a clear, cellophane like membrane called the lens capsule. During cataract surgery the front of the capsule is opened.  The cloudy lens inside the capsule is removed.  In most cases, the back of the capsule is left in one piece, and a plastic lens implant is put in place in front of the capsule. This capsule is normally clear like a glass window.

In a small number of patients, the capsule thickens and becomes a little opaque. This stops the light reaching the back of the eye. If this happens, you may notice a gradual decrease in vision, problems with glare, or things might look slightly hazy.  The capsule thickening does not damage the eye in any way; it merely makes the sight fuzzy.  Capsule thickening (also called “after cataract”) can happen at any time after your cataract operation from a few months to years. The aim of this laser procedure is to make a hole in the thickened lens capsule (called as laser capsulotomy).

Why do I need YAG laser capsulotomy?

You need YAG laser capsulotomy in order to restore your vision to how it was after the cataract operation.  The decision to have this procedure is based on the same criteria as the original cataract surgery:

  • Vision problems affecting your work or lifestyle
  • Glare caused by bright lights
  • Double vision
  • The difference in vision between your two eyes is significant
  • Another vision threatening eye disease

The procedure is not needed unless vision loss caused by clouding of the lens capsule is seriously affecting the person’s vision and lifestyle.

Can there be any complications or risks?

The laser treatment should improve your eyesight. However, occasionally there is another cause for the poor vision, such as ageing changes of the retina (macular degeneration), which will limit the improvement in your vision.

You may experience some of the following complications or risks:

  • You may notice discomfort in the eye and you will be dazzled afterwards for a short while.
  • You may notice ‘floaters’ which are black spots or lines that move around in your field of vision. These are due to the membrane breaking up following the laser treatment, and usually improve with time.
  • The pressure within the eye may rise and sometimes requires you to use eye drops to control the eye pressure. This is usually only for a few days until the eye settles following the procedure.
  • The laser may damage the plastic implanted lens, but this very rarely affects your vision.
  • There is a small chance that your vision may become more blurred due to a build up of fluid on the retina at the back of the eye, which is called cystoid macular oedema. This may require further treatment with drops and tablets.
  • There is also a small risk of developing a retinal detachment, which would require further treatment and may threaten the eyesight.

Although the above complications do occur, we take every precaution to reduce the risks and aim to give the minimum treatment necessary. The laser treatment is recommended and carried out in accordance with national guidelines.