If you’ve had the lenses of your eyes replaced due to cataracts, you’re no stranger to eye surgery. Posterior capsulotomy is a procedure done with a laser to repair a possible side effect of cataract surgery. It’s a surgery that can be done in the ophthalmologist’s office and can take as little as five minutes.
What Is a Posterior Capsulotomy?
A YAG laser posterior capsulotomy is a procedure done to help remove scar tissue after you’ve had a lens replacement.
Inside your eye, behind the iris and pupil, is a lens. This lens is clear and helps focus light onto the retina. The retina is the layer of light-sensitive cells lining the back of your eye. These parts work together to allow us to see.
When you develop cataracts, that lens becomes cloudy and is no longer clear. Cataracts result in vision difficulties such as blurry vision, double vision, sensitivity to light, difficulty seeing at night, and seeing colors as faded.
The only way to fix a cataract is with cataract surgery. In cataract surgery, the eye surgeon removes the cloudy lens and replaces it with an artificial lens called an intraocular lens. Artificial lenses cannot get cataracts, but those who have had this surgery may notice their vision become blurry again after a time.
Surrounding your eye lens is a thin membrane called the lens capsule. When your surgeon replaces the cataract lens with an artificial lens, they place the new lens inside the lens capsule. Sometimes the lens capsule becomes cloudy, a condition called posterior capsule opacification. Posterior capsule opacification is sometimes called a “secondary cataract” and has many of the same symptoms as a cataract.
Posterior capsule opacification is fixed using posterior capsulotomy. This is a surgery done with a YAG laser. Your doctor will make a small opening in the cloudy lens capsule. This allows light to filter through, bringing back your vision.
Posterior Capsulotomy Procedure
Posterior capsulotomy procedures are in-office procedures that take about five minutes.
When you first get to the doctor on the day of your surgery, a technician will measure and then dilate your eyes. In the laser room, you’ll sit at the laser slit lamp. The laser slit lamp is similar to a normal slit lamp, which is a microscope with a bright light that allows the ophthalmologist to look more closely at your eyes.
You will be awake for the procedure, so your doctor will give you numbing eye drops. Once your eyes are numb, the surgeon will use a special type of contact lens to focus the laser on the scar tissue surrounding your implant. You likely will not feel any pain during the procedure.
Posterior Capsulotomy Recovery
Depending on the tolerance for the procedure, your doctor may request you have someone drive you home. Otherwise, you should be able to do all your normal activities. Your doctor may also have you take anti-inflammatory eye drops for a week or so.
You may see some floaters in your vision for the rest of the day. Your vision will become clear after one or two days.
Posterior Capsulotomy Side Effects
Like with any surgery, there are risks with posterior capsulotomy.
Detached retina. Detached retina is a condition in which the retina comes away from the back of the eye. As a result, the retina no longer works, and your vision will become blurry. In the event that the retina becomes detached, surgery is needed to reattach it. Symptoms of a detached retina include:
- Seeing “stars” or flashes of light
- Noticing a marked increase of floaters in the eye. Some floaters are expected after a posterior capsulotomy, but they should not get worse after the first day.
- Shadows in your side vision, also called peripheral vision
- A gray “curtain” that covers part of your field of vision
Increase in eye pressure. Your eyes are full of different fluids, including vitreous humor and aqueous humor. When your eye is healthy, it maintains a consistent, stable level of these fluids. Some increase in eye pressure is a common issue. Elevated eye pressure, also called ocular hypertension, can lead to glaucoma.
Glaucoma is a disease in which ocular hypertension has caused damage to the optic nerve. The optic nerve sends signals from the eye to the brain, and if the nerve is damaged, you could lose your vision.
There are often no symptoms of ocular hypertension until it turns into glaucoma. Symptoms of glaucoma include:
- Severe pain in the eyes
- Severe pain in the forehead
- Eye redness
- Seeing rainbows or halos of light
- Blurry vision
- Decreased vision
Treatment for ocular hypertension is medicated eye drops. Early intervention can prevent glaucoma, so be sure to keep in contact with your doctor and attend all post-op appointments.
Other risks and side effects of a posterior capsulotomy include swelling in the eye or the intraocular lens moving through the opening in the lens capsule created by the surgery.
Will I Need a YAG Laser Posterior Capsulotomy?
Clouding of the lens capsule, or posterior capsule opacification, only occurs as a side effect of cataract surgery. If you’ve never had cataract surgery, it’s nothing to worry about. Not everyone who has cataract surgery gets posterior capsule opacification. About 20% to 50% of patients will deal with it within 2-5 years of the cataract surgery. Children who have had cataract surgery are far more likely to need it than adults.
The most common symptoms of posterior capsule opacification are the same as those of cataracts. If you find yourself experiencing cataract symptoms again, it’s important to contact your doctor so they can examine you. They’ll be able to diagnose posterior capsule opacification with a slit-lamp test.
Currently, scientists are working on surgical techniques that can prevent posterior capsule opacification, possibly making posterior capsulotomies obsolete in the future.