Laser posterior capsulotomy





Definition

Laser posterior capsulotomy, or YAG laser capsulotomy, is a noninvasive procedure performed on the eye to remove the opacification (cloudiness) that develops on the posterior capsule of the lens of the eye after extraction of a cataract. This differs from the anterior capsulotomy that the surgeon makes during cataract extraction to remove a cataract and implant an intraocular lens (IOL). Laser posterior capsulotomy is performed with Nd:YAG laser, which uses a wavelength to disrupt the opacification on the posterior lens capsule. The energy emitted from the laser forms a hole in the lens capsule, removing a central area of the opacification. This posterior capsule opacification (PCO) is also referred to as a secondary cataract.

PCO formation is an attempt by the eye to make a new lens from remaining lens material. One form of PCO is a fibrosis that forms inside the capsule by lens epithelial (covering) cells that migrate from the anterior capsule to the posterior capsule when the anterior lens capsule is opened to remove the primary cataract and insert the IOL. Opacification is also be formed by residual lens cortex cells. The epithelial cells can transform into myofibroblasts and proliferate; myofibroblasts are precursors to muscle cells and capable of contraction. The deposit of collagen on these cells leaves the posterior lens capsule with a white, fibrous appearance. This type of opacification can appear within days of cataract surgery. The greatest capsule opacification is found around the edges of the IOL, where the anterior and posterior lens capsules adhere and form a seam, called Soemmering's ring.

Elschnig's pearls are a proliferation of cells on the outside of the capsule. This type of PCO can be several layers thick and develops months to years after cataract surgery. Elschnig's pearls can also appear along the margins of a previously performed laser capsulotomy.

A secondary cataract will also form from wrinkling of the lens capsule, either secondary to contraction of the myofibroblasts on the capsule or because of stretching of the capsule by haptics, or hooks, used to hold the IOL in place.

Posterior capsule opacification is the most common complication of cataract removal or extraction. It does not occur when an anterior chamber lens is implanted, because in this procedure the capsule is usually extracted along with the cataract, and a lens is attached to the iris in the front part of the eye, called the anterior chamber. This technique for cataract removal is not often performed.


Purpose

The purpose of a laser capsulotomy is to remove a PCO. This procedure dramatically improves visual acuity and contrast sensitivity and decreases glare. The visual acuity before capsulotomy can be as poor as 20/400, but barring any other visual or ophthalmologic conditions, the patient will see as well after a laser posterior capsulotomy as after removal of the original cataract. Laser capsulotomies are usually performed once a patient's vision is 20/30.


Demographics

Approximately 20% of patients who undergo cataract extraction with placement of an intraocular lens into the posterior lens capsule will eventually undergo a laser capsulotomy, although a PCO may appear in up to 50% of patients who have undergone cataract surgery. The average time after cataract extraction for this procedure to be performed is two years, but it may be performed as early as three months after cataract removal, or as late as five years afterward.

Patients who fall into groups with an increased incidence of a secondary cataract formation have an increased rate of YAG capsulotomy. Patients who are younger when undergoing cataract removal are more likely to develop a PCO than are geriatric patients. This is particularly true of pediatric patients who are experiencing ocular growth. The incidence of PCO is higher in women than in men. Fifty percent of patients who experience papillary, or iris capture, of the IOL, which occurs if the IOL moves through the pupil (a hole in the iris) from its position in the posterior chamber of the eye to the anterior chamber, will form a PCO and benefit from laser capsulotomy.

The degree and incidence of capsule opacification also varies with the type of implant used in the initial cataract operation. Larger implants are associated with decreased opacification, and round-edged silicone implants are associated with a greater incidence of opacification than are acrylic implants, which have a square-edged design. These two types of IOLs are called foldable implants because they unfold after being placed in the eye, allowing for a smaller incision on the front of the eye during cataract surgery. Also, the incidence of PCO is less with a silicone IOL than with a rigid IOL. The greater the amount of remaining lens material after extraction, especially in the area of Soemmering's ring, the greater the probability of PCO formation and laser capsulotomy. Also, diabetic patients are more likely to require a YAG capsulotomy than are non-diabetic patients. This is especially true for YAG capsulotomies performed on diabetics 18 months or later after cataract removal. The extent of diabetic retinopathy does not correlate with incidence of PCO or laser capsulotomy. Finally, insufficient dilation of the pupil during cataract surgery and inexperience of the surgeon doing cataract removal contribute to an increased risk of secondary cataract formation.


Description

Laser capsulotomy is usually performed in an ophthalmologist's office as an outpatient procedure. Before beginning the capsulotomy, the patient is given an informed consent for the procedure. An hour before the laser capsulotomy, a drop of a pressure-lowering drug such as timoptic or apraclonidine is administered. A weak dilating drop to enlarge the pupil is applied to the eye. The eye may be anesthetized locally if the doctor uses a special contact lens for the procedure.

The patient then puts the head in the chinrest of a slit lamp microscope, to which a laser is attached. The doctor then may place a special lens on the front of the eye. It is important that the patient remain still as the doctor focuses on the posterior capsule. A head strap to help keep the patient's head in place may be used. While focusing on the posterior capsule, the doctor, with repeated bursts from the Nd:Yag laser in a circular manner, disrupts the PCO. An opening forms on the posterior part of the lens capsule as part of the PCO falls off of the posterior capsule and into the vitreous. Another drop of apraclonidine, or other pressure-lowering eyedrop, is applied to the eye as a preventative measure for increased pressure in the eye, which is experienced by most patients after the procedure. This is a brief procedure lasting only a few minutes and is not associated with pain.


Diagnosis/Preparation

Prior to performing a posterior capsulotomy, the doctor will perform a thorough ophthalmic examination and review any systemic medical problems. The ophthalmologic includes evaluation of visual acuity, slit-lamp biomicroscope examination of the eye to assess the extent and type of opacification and rule out inflammation or swelling in the front of the eye, measurement of intraocular pressure, and a thorough evaluation of the fundus or back of the eye to check for retinal detachments and macular problems, which would limit the extent to which the YAG capsulotomy could improve vision. A potential acuity meter (PAM) may be used to ascertain best expected visual acuity after YAG capsulotomy, and brightness acuity testing will determine the extent of glare experienced by the patient. Contrast sensitivity testing is employed by some doctors.

This procedure cannot be performed in the presence of certain preexisting ophthalmologic conditions. For example, irregularities of the cornea would interfere with the ability of the doctor to see the posterior capsule. Also, a laser capsulotomy could not be performed if there is ongoing inflammation in the eye, or if swelling of the macula (a part of the retina) is present. A laser capsulotomy would be contraindicated with glass IOLs. If macular edema is suspected, which can occur in up to 30% of patients who have undergone cataract surgery, a test called a fluoroscein angiography may also be performed.


Aftercare

After a laser capsulotomy, the patient will remain in the office for one to four hours so that the pressure in the eye can be evaluated. The patient can then resume normal everyday activities. After surgery, pressure-lowering eyedrops may be used for a week, if the intraocular pressure is raised significantly after the procedure. Cycloplegic agents to keep the pupil dilated and to prevent spasm of the muscles in the iris, and steroids to reduce inflammation may also be prescribed for up to a week. Follow-up visits are scheduled at one day, one week, one month, three months, and six months after capsulotomy.


Risks

One risk of laser capsulotomy is damage to the intraocular implant. Factors that determine the extent of damage to the IOL include the inherent resistance of a particular IOL to damage by the laser, the amount of energy used in the procedure, the position of the IOL within the lens capsule, and the focusing accuracy of the surgeon. The thicker the opacification of the lens capsule, the greater the amount of energy needed to remove it. The accuracy of the surgeon is improved when there is less opacification on the lens capsule.

In addition, during laser capsulotomy the IOL can be displaced into the eye's vitreous. This happens more often in eyes with a rigid implant, rather than with acrylic or silicone IOLs, and also if a larger implant is used. If the posterior capsule ruptures during extraction of the primary cataract, risk of lens displacement is also increased. Displacement risk is also increased if the area over which the laser capsulotomy is done is large. The most serious complication of a capsulotomy would be IOL damage so extensive that extraction would be required. This is a rare complication.

Another risk of this surgery is the re-formation of Elschnig's pearls over the opening created by the capsulotomy. This occurs in up to 80% of patients within two years of laser capsulotomy. Most of time, these PCOs will resolve over time without treatment, but 20% of patients will require a second laser capsulotomy. This secondary opacification by Elschnig pearls represents a spatial progression of the opacification that caused the initial secondary cataract.

Other risks to take into account when considering a posterior capsulotomy are macular edema, macular holes, corneal edema, inflammation of the iris, retinal detachment, and increased pressure in the eye, as well as glaucoma. These risks escalate with increased laser energy and with increased size of the capsulotomy area. Retinal detachments are usually treated with removal of the vitreous behind the lens capsule. Macular edema is treated by application of topical anti-inflammatory drops or intraocular steroid injections. Steroids control iritis (inflammation of the iris), either topically or intraocularly. Macular holes are also treated by removal of the vitreous (the substance that fills the main area of the eyeball), followed by one to three weeks of facedown positioning. Elevated intraocular pressure and glaucoma are treated with anti-glaucoma drops or glaucoma surgery, if necessary.

Finally, increased glare at night may result when the size of the capsulotomy is smaller than the diameter of the pupil during dark conditions.


Normal results

Within one to two days after surgery, maximum visual acuity will be attained by almost 99% of patients. Once the opacification is removed, most patients will not need a change in spectacle prescription. However, patients who have undergone implantation of a rigid IOL may experience an increase in hyperopia, or far-sightedness, after a capsulotomy. For a few weeks after surgery, the presence of visual floaters, which are pieces of the excised capsule, is normal. But, the presence of floaters months after this timeframe, especially if accompanied by flashes of light, may signal a retinal tear or detachment and require immediate attention. Also, if vision suddenly or gradually worsens after an initial improvement, further follow-up to determine the cause of a decrease in visual function is imperative.


Morbidity and mortality rates

The probability of a retinal detachment after capsulotomy is 1.6–1.9%. This represents a two-fold increase of retinal detachment over the rate for all patients undergoing cataract surgery, regardless if a posterior capsulotomy was done or not. Macular edema occurs in up to 2.5% of patients who undergo a laser capsulotomy and is more likely to occur when the capsulotomy is performed soon after cataract extraction, or in younger individuals. Rarely does glaucoma develop after laser capsulotomy, although as many as two-thirds of patients will experience transient increased intraocular pressure.


Alternatives

The alternative to laser capsulotomy is surgical capsulotomy of the PCO and the adjacent anterior vitreous. There is an increased risk of retinal detachment when this invasive intraocular surgery is employed. The other alternative is to leave the PCO in place. This leaves the patient with permanent decreased visual acuity.


Resources

BOOKS

Albert, Daniel M., et al. Principles and Practice of Ophthalmology, 2nd Edition. Philadelphia, PA: W. B. Saunders Co., 2000.

Gills, James P. Cataract Surgery: The State of the Art. Thorofare, NJ: Slack Inc., 1998.

Jaffe, Norman. Atlas of Ophthalmic Surgery. London: Mosby-Wolfe, 1996.

Jaffe, Norman, et al. Cataract Surgery and Its Complications. St Louis, MO: Mosby, 1997.

Steinert, Roger F. Cataract Surgery: Technique, Complications, & Management. Philadelphia, PA: W. B. Saunders, 1995.


PERIODICALS

Baratz, K. H., et al. "Probability of Nd:YAG Laser Capsulotomy After Cataract Surgery in Olmsted County, Minnesota." American Journal of Ophthalmology 131 (February 2001): 161–166.

Charles, Steve. "Vitreoretinal Complications of YAG Laser Capsulotomy." Ophthalmology Clinics of North America 14 (December 2001): 705–9.

Chua, C. N, et al. "Refractive Changes following Nd:YAG Capsulotomy." Eye 15 (June 2001): 303–5.

Hayashi, Ken. "Posterior Capsule Opacification After Surgery In Patients With Diabetes Mellitus." American Journal of Ophthalmology 134 (July 2002): 10–16.

Hu, Chao-Yu., et al. "Change in the Area of Laser Posterior Capsulotomy: 3 Month Follow-Up." Journal of Cataract and Refractive Surgery 27 (April 2001): 537–42.

Kurosaka, Daijiro, et al. "Elschnig Pearl Formation Along the Neodymium:YAG Laser Posterior Capsulotomy Margin." Journal of Cataract and Refractive Surgery 28 (October 2002): 1809–1813.

O'Keefe, Michael, et al. "Visual Outcomes and Complications of Posterior Chamber Intraocular Lens Implantation in the First Year of Life." Journal of Cataract and Refractive Surgery 27 (December 2001): 2006–11.

Sundelin, Karin, and Johan Sjostrand. "Posterior Capsule Opacification 5 Years After Extracapsular Cataract Extraction." Journal of Cataract and Refractive Surgery 25 (February 1999): 246–50.

Trinavarant, A., et al. "Neodymium: YAG laser Damage Threshold of Foldable Intraocular Lenses." Journal of Cataract and Refractive Surgery 27 (May 2001): 775–880.


Martha Reilly, OD

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


The procedure is usually performed in the office of an ophthalmologist or an osteopathic physician. The training of an ophthalmologist includes a year of internship and at least three years of residency training in the treatment of eye diseases and in eye surgery after graduation from medical school. In states where doctors of optometry are permitted by law to use lasers, and if trained in laser surgery , an optometrist may do the laser capsulotomy. A co-managing optometrist may perform some of the preoperative testing and postoperative follow-up.

QUESTIONS TO ASK THE DOCTOR


  • What are the alternatives to laser capsulotomy?
  • Am I a good candidate for this procedure?
  • What will my vision be like afterwards?
  • How many of these procedures have you done?


User Contributions:

Wg Cdr Krishnamurthy
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Apr 27, 2006 @ 4:04 am
Dear Doctor: I nned help in terms of information/guidance. I have undergone phasoemulsification for removal of catract about 8 months ago.I underwent a Yag capsulotomy about 3 months ago as ther was a glare ,particularly at Night whilst driving. Now the glare has increased and I am not driving at night as I find the incomming lights far too glaring . Please let me know if there is a way of reducing glare . I have ordered Ziess lens with anti glare coating. There is only a very very marginal change in the glare. It is still almost the glare. Can I undergo any further operation to0 eliminate glare. Thanks and regards Cdr Krish
rich k
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May 13, 2006 @ 2:14 pm
very interesting. I had YAG several days ago and
have been worried about the numerous floaters.
I guess they are normal for a few weeks to come.
Mary Lou F
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May 14, 2008 @ 4:16 pm
I had cataract surgery 2 1/2 years ago. Crystalens were placed in both eyes. During the past two years the yag laser was used on both eyes and created the opening. The formation of Elschnig's pearls have since formed, creating a haze. I was to the surgeon today and he consulted with four other surgeons as to the formation of Elschnig's pearls. They did not stop at the edge of the lens on either eye and are starting to cover the implants. The Crystalens did not give me clear intermediate or close vision so the doctor was going to implant and additional lens in front of the crystalens (but at this time is not because of the formation of Elschnig's pearls). He is going to gather more information on removing the lens and replacing it but needs to talk with someone has has done this more than once. Can you add any information to this? Thanks!
Joseph G. Alam
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Oct 7, 2009 @ 7:19 pm
Dear Doctor: I reached my 90th birthday a couple of weeks ago. All my life I had astigmatic myopia. In my 80s my presription as about 20/300+ but I always could see fine with the prescribed glasses. My optometrist kept my vision sharp but advised me there were incipient cataracts and sent me to a "laser factory." All went well and for several months I had 20/20 vision, but the ocular muscles were unchanged anf glasses were resumed, especiall for prism that was required because of a lazt (?) eye.
I now am relocated and the current ophthalmologist says I should get a capsulotomy. I have no vision problems but too much reading quickly fatigues the eyes and causes watering. The muscular movement is not as effective and 4-pt type causes discomfort; I am a crossword addict. Is it adviseable to forego any operation until discernible impairment of vision occurs? Thank you!
K. Clark
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Nov 3, 2009 @ 5:17 pm
I have never seen without cloudy haze and blurring since the original cataract surgery. My doctor prescribed eye moisteners and anti-inflammatories for an extended period but it did not help. Then came the YAG. That helped almost not at all, but a little. Is it advisable for the YAG to be done a second time?
Suzanne S.
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May 27, 2010 @ 10:10 am
I had cataract surgery last year and kept my 20/20 vision. I had YAG on my one eye on Monday of this week (it's Thursday now) and the next day (and still today) have trouble seeing the large "E" at the top of the eye chart. The HMO doctor put me on steriod eye drops and told me to come back in two weeks. My vision is so much worse than before the YAG. This is very scary.
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Jul 6, 2010 @ 6:18 pm
I underwent the Yag capsulotomy in May and I regret having it done--I had much better vision before the procedure. When seen the day after the procedure, my vision was very poor and I had so much irritation I was put on steroid drops for 2 weeks. It has been almost two months now and I get black floaters and my vision is still very poor. The M.D. doing the procedure in the HMO told me this is the first time she had this happen to anyone. She said it was due to a medication, but she had my list of medications prior to doing this procedure and okayed all the medications--plus she had the list of my medications on the HMO computer system and that makes it available to all the doctors in the HMO. I specifically asked her if there were any problems with my meds before the procedure and she said no.

This has left me very worried as I have a second cataract implant and was told that will get clouded and need a YAG capsulotomy also. But I don't know that it is worth it.
Louise C. Johnson
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Aug 24, 2010 @ 6:18 pm
I read the comments on this procedure and think that maybe it is not advisable and a waste of time and money to have it done. Plus, the pain the patient goes through. It appears to me that this procedure needs to be improved in order to cut down on complications. I am leery now to have this procedure done if I need it after my cataract surgery. Is there a better methods. Or--- is the surgical one better than the laser one?
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Nov 5, 2010 @ 11:11 am
I had laser capsulotomy done 4 days ago. I have pain in my eye similar to a bad headache and I am extremely light sensitive. Is this normal? I also have floater but I was told to expect those. I wasn't told about any pain or light sensitivity.
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Nov 16, 2010 @ 9:21 pm
Can you tell me, if this YAG Laser surgery can work on a patient who has macular degeneration? She is an 80 year old woman, diabetic, and has had cataract surgery within the last 5 years.
Thank you.
Barbara Cattunar
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Dec 15, 2010 @ 3:03 am
Thanks for all the information. Do you endorse the Health Sciences Institute, which is featured on your site, claim for effective treatment via eye drops for cataracts? I'm not too sure about that
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Dec 27, 2010 @ 9:21 pm
Yag lazer capulotomy has been suggested to clear my vision after cateract surgery six months ago.

1. For how many years has this operation been performed?
2. Are there long term (eg 10 year or longer) complications for this operation?
3. Is the lens capsule compromised or weakened over time with the hole?
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Jan 11, 2011 @ 3:15 pm
I had cataract surgery followed last summer by posterior capsulotomy laser sergery in both eyes to correct the glare I expereinced following the cataract surgery. The glare seems worse following the laser surgery. My doctor did not offer any remedies for this. What else can I do about the glare, especially at night?
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Feb 14, 2011 @ 9:09 am
After the YAG surgery, I had a scratched cornea. Very painful!!! How could this have happened?
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Jun 13, 2011 @ 4:04 am
I am scheduled for Nd YAG posterior capsulotomy laser sergery in both eyes the day after tomorrow. I had undergone Cataract surgery in both eyes 2 years ago. I am 63 years old. Though the doctor tells me it is very safe, I am confused after reading the above comments. Is it really safe? Can I get a reply urgently/
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Jul 26, 2011 @ 5:17 pm
I HAD MY LEFT EYE CATARACT SURGERY ( FOR INTERMEDIARY VISION )DONE ON 10/2010 AND ALMOST HAZY SINCE EVEN WITH PRESCRIBED GLASSES. GLARE PROBLEM WITH ON COMING HEADLIGHTS, HAZY AND CLOUDY VISION, CONTRAST PROBLEM IN READING COMPUTERS ESPECIALLY WITH BLUE LETTERS EVEN WITH CORRECTIVE LENSES. I SUSPECT IT IS PCO BUT OPTOMALOGIST NEGATED IT. THEY PROBABLY DO NOT WANT TO PERFORM A YAG LASER TOO EARLY OR UNLESS IT IS REALLY NECESSARY, I GUESS. BUT I AM POSTPONING THE RIGHT EYE ( NOW -5.25 ) SURGERY UNTIL THIS LEFT EYE ISSUE IS TAKEN CARE OF.
jill
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Jan 6, 2012 @ 9:09 am
I had cataract surgery 2years ago and now have posterior capsular opacity in both eyes.I also take medication for epilesy. Further, I have a Medtronic interstim implant which means Ican't have diathermy anywhere on my body.Is a YAG laser safe? Are lasers a form of diathermy since they have a magnetic field? My opthalmic surgeon is of the view it is safe but can't guarantee it and so has discharged me until I find out more details for myself.He has suggested I try the Internet or the manufacturer.The manufacturer referred me back to my Consultant physician who never gets back to me;The junior surgeon I spoke to did not even know that a laser had any connection with electromagnetism.
Getting an appointment via re-referral from GP will take many months. Will this mean my condition will worsen making laser treatment less likely to be successful?Who do I turn to for appropriate advice?
Alain FCY
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Feb 22, 2012 @ 11:23 pm
useful article regarding the post cataract surgery complications. i also got secondary cataract and Elschnig's pearls after more than one year after a PCO...
Maha
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Jul 18, 2012 @ 1:13 pm
Hi
I am 51 years old and had retinal detachments and cataract surgery in both eyes.
My question is about the right eye. In 2008 I had a cataract surgery in that eye. Two years later (December 2010) I had a retinal detachment in that same right eye for which I had a buckle and a vitrectomy done. Two years after that ( July 2012) another eye doctor told me I have a clouding of my lens and he proceeded to do a yag laser. However one week now after the yag laser procedure, my vision is still blurry for distance yet my vision for reading improved. I would like to know why my yag laser did not work and why a change in vision? doctor said I can correct it with lasik but did not reccomend that I do another lens implant? why did yag laser not work, was something not done right? Thanks
Joyce Ellis
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Aug 22, 2012 @ 11:11 am
I am scheduled tomorrow for the YAG capsulotolmy (right eye) and all of the above complaints are really making me apprehensive. None of the comments mention good results. I am 68 years old and had the ChrystaLens placed in this eye 11.11.2010. At my check up visit after the IOL was placed I mentioned cloudy and was told it was condensation and taht the eye hurt. He recommended warm compresses.
On 8/21/12 I went to a retina specialist because I woke up with spider shaped floaters and noticed C shaped flashes of light in the left eye. I have AMD but the left eye is worse than the right eye. I cannot read when I cover either one of my eyes. The letters are doubled. All of this makes me wish I had not spent almost $10,000 and just left the first cataracts in my eyes.
carol
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Jan 1, 2013 @ 11:11 am
My husband has cloudiness in 1 eye & has been told he needs the YAG capsulotomy. He wants to wait 3 months. Is there a risk in waiting & does it get worse over time?
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May 6, 2013 @ 7:19 pm
It is now 8:00PM . My husband had capsulotomy surgery at noon today. Right now he is experiencing pain and scratchiness in the eye, and is really suffering. We have called the surgeon's office, and we were told to keep up with the Prednisone treatment, and also use Genteel artificial tear drops when needed, and all will be better tomorrow. Thus far, nothing has worked. The pain/ scratchiness is still severe. Could this be a tear in the cornea, or the beginning of retinal detchment?

Thank you.

Gae
Blair
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Jul 1, 2013 @ 1:01 am
Had a lens implant in rt eye in 2004 50 yrs old then. had yag a few weeks ago and cannot read print without much stronger reading glasses. Blurry vision has been consistent since yag and is really impaired my vision. Floaters not really a problem although one returns occasionally.Battled skin cancer recently and problems with root canals that left me with permanent nerve damage. All this stuff was done to prepare for a hip replacement in about 7 weeks. This is small potatoes compared to many battling major issues. Did anyone's blurry vision ever clear up or do we live with the problem. My doctor thinks my vision problems are because of the RK surgery 23 yrs ago. Fluctuation mostly. Anyone experiencing any of these eye problems? Thank God I can still play the harmonica.
Niki
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Sep 8, 2013 @ 12:00 am
My grandmom is 75 years old and had got cataract surgery done around 15 years back and now shes facing a problem of PCO and is recommended Yag laser capsulotomy in both the eyes which is been scheduled tomorrow. Till now i was very confident with getting this secondary cataract surgery done causing no side effects or having minimal risks as the doctors here explain that it is very safe and very common but after reading the above comments i am literally confused whether its safe or not!! Kindly suggest whether it is actually safe or not?? or i should consult more doctors before the surgery.
Kindly give the best possible solution, Your reply is awaited.
Thank You
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Oct 21, 2013 @ 1:01 am
I had cataract surgery in both eyes and then the yag procedure in both eyes, left is worse , having much blurring and glare which is causing many problems with my current job..after the yag procedure, I was told to leave the outpatient surgery center and was told I could go to work, i advised that my vision was blurry after the procedure.. Driving at night is bad, I feel like the cataracts are still there. My doctors office is not returning my calls at this point, I need to go for another opinion as to what is wrong with my vision.. I wish I would have been advised how risky the YAG was, I have been reading alot on the internet about this and the symtoms I have been complaining about are all in the articles I have read. Please reply..Thanks
Beverley Mas
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Jan 18, 2014 @ 10:22 pm
I am a 77-year-old woman who was very happy with my cataract surgery in both eyes two years ago. Having developed opacification in both, I am now scheduled in a week for yag posterior capsuotomy in both. The foregoing list of comments, I who have always considered myself brave and a risk-taker am petrified! Please, someone send me something hopeful! I am a published writer and currently still working at a college as an Academic Counselor -- NEED MY EYESIGHT! Thanks to anyone who will take the time to ease my mind!
Richard Orselli
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Mar 31, 2014 @ 11:11 am
I am 80 y/o and had a IOL implanted in the Left eye four moths ago. Yesterday it was recommended that I have a YAG capsulotomy to correct the developing PCO of the left eye. Has anyone had positive results without discomfort, glare, persistent floaters or other side effects? Thank you.

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