What is a YAG Capsulotomy?
A YAG capsulotomy is a laser surgical procedure that may be performed months or years after cataract surgery. A YAG capsulotomy is performed if posterior capsular opacification (PCO) develops after cataract surgery. PCO occurs in up to 50% of patients who undergo cataract surgery. PCO forms because during cataract surgery, some residual cataract cells may be left behind, which can overtime proliferate, leading to cloudy vision. YAG capsulotomy is the quickest and safest option to remove PCO. During the YAG capsulotomy, the ophthalmologist will remove the PCO with laser pulses of light.
Key Takeaways
- A capsulotomy is a common laser surgical procedure that is performed months or years after initial cataract surgery. It is not the same procedure as cataract surgery.
- Capsulotomy is done to remove the posterior capsular opacification that forms after cataract surgery.
- Capsulotomy is painless, only takes a few minutes, and restores vision.
Understanding Capsulotomy
Everyone will eventually develop cataracts. Cataracts are a natural clouding and yellowing of the lens inside of the eye. Cataracts start to form around 40-50 years of age. They tend to worsen and get denser as years go by, eventually making the vision blurry and cloudy. The main symptom of cataracts is blurred vision, like looking through a dirty windshield of a car. Other symptoms are glare, trouble driving at night, and changes in color perception.
Cataract surgery is performed to remove the lens inside of the eye and replace it with a brand new, artificial lens. The artificial lens will make the vision clear again. Most people report having great vision after cataract surgery. However, a ‘secondary cataract’ can develop in up to 50% of people who get cataract surgery. A ‘secondary cataract’ isn’t really another cataract, but the proliferation of residual cataract cells that were left behind during the original cataract surgery. This ‘secondary cataract’ is called a posterior capsular opacification (PCO), and typically presents with cloudy vision and glare. A Neodymium:yttrium-aluminum-garnet (YAG) capsulotomy is performed to remove the PCO, and make the vision clear again
Procedure of Capsulotomy
The YAG capsulotomy procedure is performed in the office using a YAG laser:
- Dilating eye drops will be put into the eye to dilate the pupil and visualise the PCO
- Topical anaesthetic drops will numb the eye
- The patient will sit upright with their forehead against the forehead rest and chin against the chin rest.
- The doctor looks through the microscope at the patient’s PCO
- The ophthalmologist will point a laser beam at the PCO and create an opening
Types of Capsulotomy
- Anterior capsulotomy: is performed during cataract surgery to access the cataract, and should not be confused with YAG capsulotomy.
- Posterior capsulotomy: is another name for YAG capsulotomy which is done to remove posterior capsular opacification (PCO) after cataract surgery.
Risks involved in Capsulotomy
Post-procedure complications resulting from YAG capsulotomy are rare. However, serious complications may occur in rare cases, which include
- Retinal detachment
- Increased intraocular pressure
- Inflammation
- Macular edema
- Dislocation of the artificial intraocular lens
