Secondary Cataract/YAG Laser

Posterior Capsule Opacity and Laser Capsulotomy

One of the most common problems after cataract surgery is clouding of the membrane around the lens. The membrane is referred to as the posterior capsule, and once the membrane becomes opacified, the condition is termed posterior capsule opacification, or, PCO. A cloudy posterior capsule causes blurry vision, but this condition can be treated easily and safely with a laser treatment in the office or outpatient center.

During cataract surgery, your surgeon will remove the cloudy natural lens of your eye (the cataract) and replace it with an intraocular lens (IOL). Much of the thin clear membrane that surrounds the natural lens (called the lens capsule) is purposely left intact during surgery, and the IOL is typically implanted within it.  When the cataract is removed, your surgeon makes every attempt to maintain the integrity of the lens capsule so that the IOL is held and protected.

However, in about 40-50 percent of patients, the posterior portion of the capsule becomes hazy after cataract surgery, causing a PCO. Posterior capsule opacification occurs because cells within the eye grow on the capsule. In some cases, if the condition progresses significantly, your vision may be worse than it was before cataract surgery.

Treating Posterior Capsule Opacity with a YAG Laser

Fortunately, a YAG laser can treat posterior capsule opacity safely, effectively and painlessly. This procedure, known as YAG laser capsulotomy, is performed in your doctor's office or as an outpatient.

  • YAG laser capsulotomy involves just a few simple steps:
  • Dilation of the eye is done with eye drops.
  • A laser removes the hazy posterior capsule from your line of sight without making an incision or touching the eye.
  • Drops may be given after the procedure to reduce inflammation.
  • The procedure takes only a few minutes and is painless.

Following a YAG laser capsulotomy, you may resume normal activities immediately. You may experience some floaters (or spots in your vision) afterward. These will likely resolve within a few weeks.

Most people can expect their vision to improve within a day. As with any eye procedure, however, call your eye doctor immediately if vision worsens or fails to improve.


YAG Laser Capsulotomy Risks

Although a YAG laser capsulotomy poses slight additional risks, overall the procedure is extremely safe. The most important risk is that the retina can become detached from the inner back of the eye.  This complication is rare, with or without the laser procedure.

Statistics suggest that the lifetime risk of a detached retina after cataract surgery is about 1 percent. That number rises to about 2 percent after YAG laser capsulotomy. It is important to be aware of these risks and notify your doctor if you notice any new flashing lights or floaters.