A Yag (Yttrium Aluminium Garnet) capsulotomy is a special laser treatment used to improve your vision after cataract surgery. It is a simple, commonly performed procedure which is very safe. During your cataract operation, the natural lens inside your eye that had become cloudy was removed. After cataract surgery, the cataract will never come back. However there is about a 50/50 chance that a protein film will form across the posterior capsule. This protein material is generated from microscopic cells that cling to the anterior capsule and the equator of the natural lens which became a cataract.
During cataract surgery it is impossible to remove every cell because of their microscopic size and location. After cataract surgery these cells continue to produce the same protein material that they did before cataract surgery even though the lens is now gone. In about 50% of patients the film will migrate across the posterior capsule creating what eye doctors refer to as “capsule clouding” or “Posterior capsule opacification (PCO)”. This process usually takes a year or two to cause visual blurring, but it has been seen as early as three weeks following cataract surgery. It is easily corrected with the YAG laser. A new plastic lens was put inside the lens membrane (called the bag or capsule) in your eye. In a small number of patients, the capsule thickens after surgery and becomes cloudy. This interferes with the light reaching the back of the eye. When this happens, your sight becomes misty, and you may get glare in bright light or from lights at night-time. Capsule thickening can happen in the months after your cataract operation, but more commonly occurs about two years after surgery. Yag laser capsulotomy is the only way to treat this. Apart from affecting your vision, the thickening does not damage the eye in any way. In a Yag laser capsulotomy the doctor uses a special lens to apply a laser beam to the capsule. This creates a small hole in the centre of the capsule, which lets light through.
Problems after cataract surgery are rare but can occur. Sometimes the tissue that encloses the artificial intraocular lens becomes cloudy and blurs the vision. This is known as a secondary cataract, even though it’s not a true cataract. This can develop months or even years after cataract surgery. This outpatient procedure is treated with a laser, called YAG laser capsulotomy.
The YAG (Yttrium-Aluminum Garnet) laser uses laser light in a focused beam to make small openings in the posterior capsule to clear the clouded membrane. No anesthetic is required since the capsule has no nerve endings and therefore there is no pain, just like hair or finger nails can be cut without pain. How does the laser pass through the cornea (the clear front window of the eye) without damaging it? The laser is a “focused” beam of light and only affects the tissue that it is focused on. An example of focused light would be holding a magnifying glass to focus sunlight on a piece of paper to burn it. For this reason patients can blink during the treatment without any harm to their lids or other eye structures. In this way the YAG laser clears the membrane and takes away any frame work for the protein to build on. The protein material can continue to form in the periphery (called Elshnig pearls) where in most cases vision is not interfered with but the visual axis or line of sight remains clear. So, once the capsule clouding is cleared it is usually permanent.
The YAG laser is the laser used to clear the frosting from the back surface of an intraocular lens. YAG laser treatment is painless and is completed from outside the eye in a few minutes. During YAG laser treatment your eye doctor may use a magnifying contact lens to help with aiming the YAG laser at the layer of frosting. During the treatment patients will see flashes of light and hear a clicking sound. The pupil needs to be dilated before YAG laser can be performed to allow a good view of the lens surface. After the treatment your doctor will prescribe a short course of anti-inflammatory and pressure drops. Most patients will noticed an improvement in clarity and vision within a day. YAG laser treatments are typically only needed once as the capsule does not regrow after it is vaporised by the YAG.
Complications after YAG laser are very rare but can in rare cases include vitreous floaters, raised eye pressure, retinal swelling, lens damage and very rarely retinal detachment.
Common Questions About YAG LASER Procedure :
Q: Why Do I need this procedure?
A: After cataract surgery, there is a 50/50 chance that a protein film will form across the posterior capsule. This protein material is generated from microscopic cells that cling to the anterior capsule and the equator of the natural lens which became a cataract. It is almost impossible to vacuum every remaining cell at the time of surgery. The cells left behind will continue to produce protein. This is called capsule clouding.
Q: What is a YAG Laser Capsulotomy?
A: A YAG Laser Capsulotomy is a laser procedure where the eye(s) is dilated, giving the doctor a view of the protein buildup behind the implanted lens. The YAG laser clears protein film to restore vision.
Q: Is the YAG Laser Capsulotomy done just like cataract surgery?
A: No. This procedure only takes 1-2 minutes of treatment for your eye(s). There is no pain involved since nothing will touch your eye(s). You will sit behind the YAG laser (which looks like a microscope) and will look where the doctor tells you. On average, about 50 pulses from the laser will be used to treat your eye. Once the procedure is complete, it should not have to be repeated again in the future.
Q: What if I blink during the procedure?
A: It's okay to blink during the procedure. The laser has a focused beam of light that only affects the tissue that it is focused on, with no harm to your lids or other eye structures. No lid holding device is required.
Q: What does YAG stand for?
A: YAG stands for Yttrium, Aluminum and Garnet crystals used to generate the laser.
Q: Are there any restrictions before or aftermy procedure?
A: No. You may go about your daily routine, take your medication(s) as directed and you can eat your normal meal(s) before your procedure. There are no eye drops you need to take, but if you take eye drops for other reasons you may continue to do so. You will notice that your vision may be blurry for a few hours due to your eye(s) being dilated and you may notice new floaters in your field of vision (this will eventually decrease over a period of time). These floaters never actually go away, but they do gradually settle down by gravity over a few months.
Q: Will I need a new glasses prescription after this procedure?
A: When you go into your follow-up appointment, your doctor will recheck your prescription and change it at that time if needed.