Laser capsulotomy

Introduction

This information sheet has been given to help answer some of the questions you may have about having a Yag laser Capsulotomy. It explains the benefits, risks and alternatives of the procedure as well as what you can expect when you come to the clinic. If you have any questions and concerns, please do not hesitate to speak to a doctor or nurse caring for you.

What is a Yag laser Capsulotomy?

A Yag Capsulotomy is a special laser treatment used to improve your vision after cataract surgery. During your cataract operation, the natural lens inside your eye was taken out of its bag, and a new plastic lens was put into the bag inside your eye. This bag is referred to as a ‘capsule’. In a small number of patients the capsule thickens, and becomes a little opaque, like a frosted glass window. This stops the light reaching the back of the eye. When this happens, your sight becomes misty, and it can become difficult to see at night, or in sunlight.

Capsule thickening can happen in the months after your cataract operation, but more commonly occurs two or three years after. The thickening does not damage the eye in any way; it merely makes the sight fuzzy.

What is the procedure for Yag laser Capsulotomy?

You will attend for approximately 1-2 hours. The treatment will be performed in one of our laser treatment rooms. Special preparations such as fasting and changing into operating theatre clothes are not necessary. It is important that you use your regular eye medication drops as normal on the morning of your laser treatment unless your doctor has told you otherwise. You will then have some more drops instilled into your eye. These are usually a mydriatic (drop to make the pupil big), a drop to lower the intraocular pressure and an anaesthetic eye drop to numb the eye. You will then sit at a machine similar to the machine used to examine your eyes when you routinely visit the eye clinic. However, there is a special laser attached to this machine. The doctor will use a special lens to apply the laser beam to a small hole in the centre of the capsule, and this drops to the bottom of your eye.

 

What are the benefits of having a Yag laser Capsulotomy?

The laser treatment is to remove the cloudy capsule thickening in your eye, which is aimed to restore your vision to how it was after the cataract operation. You should benefit with better vision after the treatment.

 

Are there any risks associated with a Yag laser Capsulotomy?

Complications after this treatment are uncommon. Occasionally the intraocular pressure rises immediately after the laser treatment. If this occurs, you may need extra treatment before you can go home. This is usually eye drops that the doctor or nurses instil whilst you are still at the clinic, or it may be tablets. You will be asked to remain in the department until the pressure has reduced to a satisfactory level. This may only take a few hours at most.

Occasionally the laser beam opening is incomplete or not big enough. This will be discovered either after your treatment, or on your follow-up visit. If this is the case, it will be necessary to repeat the treatment at a later date.

Less often the laser can disturb the retina. Very rarely a little fluid can build up in the retina. Also very occasionally the laser can disturb the retina, the light sensitive membrane at the back of the eye.

Certain symptoms could mean that you need prompt treatment, including:

  • excessive pain
  • loss of vision
  • flashing lights
  • increasing redness in the eye

If you experience any of these symptoms telephone the Kersley Clinic for advice immediately. Or after hours, visit your nearest accident and emergency (A&E) department.

Are there any alternatives?

An alternative to a Yag laser Capsulotomy is to do nothing. The capsule may or may not continue to thicken. If it does, you may wish to consider a Yag laser Capsulotomy at a later date. Although this will not remove the cloudy capsule, it may help to keep your vision to a satisfactory level for you. Occasionally a change in your glasses prescription can also improve your sight.

 

What do I need to do to prepare for the laser treatment?

As this is an outpatient treatment, you can eat and drink as normal. You must take your eye medication as normal on the morning of the laser treatment.

 

What happens after the procedure?

You may be seen a few weeks after the laser treatment to make sure the laser has adequately removed the selected part of the capsule. You should be given this follow-up appointment before you leave after the treatment.

If you have discomfort once you have returned home, we suggest that you take a pain reliever such as paracetamol as required per instructions on the packet.

It is normal to feel itching, sticky eyelids and mild discomfort for the day after the laser. The eyes will feel normal the following day. The eye drops can also take some time to wear off and you should not be alarmed if your pupils are still big for several hours after the treatment. These drops can also cause your near vision to be blurred and sunshine to seem quite bright and dazzling. Do not panic. The drug will have worn off by the morning and your pupils should be back to their normal size again.

You should not drive or ride a motorbike or bicycle until your pupils have returned to their normal size.

You may also find that your vision is a little hazy, similar to looking through a smoke-filled room. This is normal, and your vision should return to how it was before the laser by the next day.

 

What do I need to do after I go home?

Anti-inflammatory drops may be prescribed after the laser treatment. These help to minimise inflammation (not infection) within the eye. These are usually only for a few days to a week. You do not need antibiotics as there is no open wound on your eye.

If you are using glaucoma drops, please continue using them as you would normally.

You can do all the daily activities that you would normally without any problems.

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