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YAG Laser Capsulotomy for PCO

What is posterior capsule opacification (PCO)?

The lens inside the eye is enclosed in a cellophane-like layer called the lens capsule. During cataract surgery, the front part of the capsule is opened to remove the cataract (cloudy lens), and the back part of the capsule is kept, called the posterior capsule, to allow the insertion of a lens implant. Normally, the posterior capsule is like a clear membrane; however, in a small number of patients, the capsule may thicken and become opaque over time. This is called posterior capsule opacification (PCO). If this happens, you will notice a gradual reduction in your vision and glare.

Posterior capsular opacification can occur at any time after cataract surgery, from a few months to years. It can cause the vision to be blurry, but it does not damage the eye in any way.

Mr Ellabban will always do a full assessment to make sure that the posterior capsule opacification is the main cause of the blurry vision and there are no other problems in the back of the eye.

What is YAG Laser capsulotomy?

This is a type of laser treatment that aims to make a hole in the opacified posterior capsule of the lens (called posterior capsular opacification).

The treatment is performed at the eye clinic. The doctor will put some dilating drops to dilate (open) your pupils. Then you will be taken to the laser room.

You will be asked to sit on a machine very similar to the eye examination machine. The doctor will put some numbing drops, put a contact lens to stabilise the eye and perform the laser. The treatment takes only a few minutes. During the laser treatment, you may see some flashes of light and hear clicking noises. The treatment is not painful and effective in most cases (you will notice an improvement in your vision the next day).

Following the laser, your vision will be blurred for a few hours due to the effect of both the dilating drops and the bright flash of the laser. You will usually feel improvement in your vision the next day, and you can resume driving and normal activities. You may notice some floaters, which usually resolve in a few days or weeks.

How successful is the laser in improving vision?

The laser treatment is successful in more than 99 % of cases in opening the membrane of scar tissue, and you would expect your vision to improve after treatment. However, if there is any other existing problem in other parts of the eye, such as the retina, there may be only a limited improvement after the treatment.

Therefore, it is important to do a thorough examination before performing the laser treatment to make sure that the posterior capsule opacification (PCO) is the main reason for blurred vision.

What are risks of YAG Laser capsulotomy?

YAG laser capsulotomy is a very safe and effective treatment. The risk of complications is rare. These can be:

  • Build-up of fluid in the back of the eye, known as macular oedema (rare).
  • Retinal detachment (very rare).
  • Lens implant displacement (very rare).
  • Laser may damage the plastic lens implant, called lens pitting, but this rarely affects vision.
  • Temporary increase in eye pressure (often treated with drops).

If you feel your vision did not improve after the laser or experience any new symptoms, you should contact the doctor for an eye examination.