A laser is a high-tech device that produces very high-energy light beams that can cut tissues in certain types of surgery. Most cataracts are removed surgically by a method called extra-capsular cataract extraction. In this procedure the front part of the capsule – the membrane enclosing the cataract – is opened and the cloudy lens is removed; the back part of the capsule is left in place to support a plastic intraocular lens (IOL). Many months or even years after the surgery that capsule remnant and some remaining lens cells may become cloudy and cause blurry or poor vision. It may seem to you as if the cataract has returned.
The cloudy remnant is called posterior capsular fibrosis. If you develop capsular fibrosis—about half of cataract patients do – that becomes so opaque that you have trouble seeing through it your vision can be made clear again with a procedure called a laser capsulotomy. This quick and painless surgery involves using a laser to cut an opening in the posterior membrane. Nothing has to be removed as it did with the original cataract surgery.
YAG Laser and Capsulotomy
A laser is a high-tech device that produces very high-energy light beams that can cut tissues in certain types of surgery. It has significant advantages over a scalpel. Not only can it make more precise cuts it can make them inside the eye without needing an incision through the outside of the eye. There is almost no risk of an ocular infection and no problems related to wound healing.
A YAG laser is used to painlessly cut a small opening in the capsule remnant. Amazingly it can cut behind the IOL without damaging the IOL. It is not necessary to remove the entire capsule but only to make an opening in the center to allow the clear passage of light rays. Enough of the posterior capsule is left to hold the IOL in place.
How Is the Surgery Performed?
Laser capsulotomy is an outpatient procedure. It does not require hospitalization or general anesthesia. You will be comfortably seated in front of the laser instrument. The surface of your eye will be numbed with anesthetic eyedrops. A special contact lens will be placed on your eye to help in focusing the laser beam. It also will prevent you from blinking during the procedure. As you look at a target the doctor will look through a slit lamp (clinical microscope) to direct the laser beam at the area being treated. Each time the laser is “fired” you will see a flash of colored light and hear a quick tapping sound. After the surgery you should begin to see well within a few hours. Your eye doctor may check your eye pressure later that day or the next. He or she may also give you eyedrops or an ointment. Once the posterior capsule has been opened it won t cause your vision to cloud again.