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YAG Laser Capsulotomy
One of the commonest complications which can occur after cataract surgery implantation is Posterior Capsule Opacity. This causes the previously clear vision to deteriorate and become blurry or cloudy, and causing glare from lights at night-time or from bright lights.
YAG Laser Capsulotomy is an out-patient laser procedure that creates a clear opening through the clouded posterior capsule so that vision is restored to its previous clarity.
Increase in floaters: These appear like dots or wavy lines in the vision and they are the commonest side effect of this treatment, but they are not serious, and people learn to ignore them after a little while.
Increased pressure in the eye: This can occasionally occur immediately after the laser treatment. Before you are discharged to go home, additional treatment with eye drops or tablets will be provided, and you may be asked to remain in the clinic until the eye pressure has dropped to a satisfactory level. Typically this may take a few hours at most.
The laser capsulotomy opening is not large enough or is incomplete: The treatment will need to be repeated at a later date.
Extremely rarely, macular oedema (swelling) and retinal detachment have been reported as possible complications. Retinal detachment can produce a shadow in the vision or flashing lights accompanied by large floaters. Such symptoms, or any new blurring or distortion of vision should be reported urgently to your doctor for further investigation.
Mild eye inflammation, lens dislocation and lens damage (pitting) which reduces the clarity of the new artificial lens have also been reported as rare complications.
At your pre-treatment assessment, check that any underlying medical conditions you may have such as diabetes, hypertension or cardiac disease have been disclosed and discussed. Special preparations such as fasting or wearing operating theatre clothes will not be required as the treatment will be done as a day case outpatient procedure, lasting for about half a day.
You will be asked to sign a consent form which will set out the risks and benefits of the treatment, after they have been discussed with you. Measurement of your vision and eye pressure will be done. You will have some drops put into your eye to widen the pupil, and an anaesthetic eye drop to numb the surface of the eye. As a result of these drops, your vision may be blurred for about 4 hours. You may have drops of apraclonidine (“Iopidine”) before the treatment to help prevent rises in eye pressure, but this may be omitted if you have a history of ischaemic heart disease (heart attack or angina). If you have heart problems, especially severe angina that has required surgery or vascular stenting, it is important to ensure that your doctor is aware of this.
You should urgently report the following symptoms: Excessive pain, increasing redness of the eye, loss of vision, a shadow in the vision, flashing lights, sudden appearance of large floaters.
You may take your usual pain relieving tablets following the instructions on the pack, if you have some discomfort when you are at home. It is normal to have itchy, gritty or sticky eyes and mild discomfort for the remainder of the day after the treatment. You will be given a follow-up appointment a week or so after your laser treatment to ensure that the eye has settled down normally and to assess the success of the treatment.
This outpatient laser procedure is simple, commonly performed and very safe. Complications resulting from YAG laser capsulotomy can sometimes occur but they are very uncommon.
Focussed on Excellence
Mr Kuang Hu, MA MB BChir PhD FRCOphth, completed his medical degree and research doctorate at the University of Cambridge before training in Ophthalmology on the London Registrar rotation. He is a Consultant Ophthalmic Surgeon at Moorfields Eye Hospital NHS Foundation Trust.
Mr Hu's expertise encompasses cataract surgery and the management of glaucoma. He provides medical, laser and surgical glaucoma treatments, including trabeculectomy and aqueous shunts. He also handles all aspects of General Ophthalmology.
Your eyesight matters and often cutting cost means reducing quality. It's worth investing in personalised treatment plans, state-of-the-art technology, and carefully tailored care delivered by a highly-qualified consultant.
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