What does the treatment involve?
Cataract surgery involves removing the eye's natural lense or the opacified "crystalline lens" in which it is found.
This capsular bag must be cleaned and left transparent before finalising the surgical operation, given that this is when the artificial intraocular lens is implemented to substitute the eye's natural crystalline lens.
Months or years after cataract surgery decreased vision might be notice. This is due to an opacification of a part of the capsular bag called the "posterior capsule". A posterior capsule opacity, known in the past as a "secondary cataract", is treated quickly and simply via a procedure called a Nd:YAG laser posterior capsulotomy.
Treatment involves restoring transparency to the posterior capsule by making an opening in it with a Nd:YAG laser without the need for incisions.
How is it performed?
To carry out a capsulotomy, around 30 minutes before the intervention the pupil is dilated using eyedrops. Then, some anaesthetic drops are applied and the laser is applied. This is painless and usually lasts a few minutes.
Very rarely, in cases where patients do not collaborate adequately, a lens that is put on top of the eye is used. Once the procedure is finished, anti-inflammatory and anti-hyperintensive eyedrops are applied and the patient is discharged after checking that everything is in order.
It is an outpatients treatment and does not require any prior preparation by the client. It is advisable to be accompanied by someone as you may experience passing glare due to the light of the microscope used to carry out the procedure. You can usually take up your daily activities the day after the operation.
After a few days during which anti-inflammatory eyedrops should be used, an eye checkup is performed to check the patient's progress and the final results.
An evident improvement is usually noticeable just a few hours after if the patient does not have any eye issues that would impede proper visual recovery.
People frequently report that they see "floaters" for the first few days after treatment, a phenomenon that passes in a few days but may occasionally last for a little longer.
An Nd:YAG laser posterior capsulotomy is a non-invasive and very safe procedure. Occasionally, the intraocular pressure of some patients increases temporarily, which usually happens during the first few hours after the treatment is performed.
To avoid this complication, antihyptensive eyedrops are applied immediately after the laser is applied. Furthermore, to counteract the postoperative inflammatory repsonse, anti-inflammatory drop are prescribed for a few days as mentioned before.
Professionals who perform this treatment
Frequently asked questions
Might it be necessary to repeat a Nd:YAG laser posterior capsulotomy?
A Nd:YAG laser posterior capsulotomy is a definitive treatment that is usually perfomed in a single session. However, there are a few very cases where opacity is reproduced, which means the ophthalmologist has to repeat the procedure again.
Is the recovery from a YAG laser capsulotomy quick?
Recovery is very fast. Practically as soon as the procedure is finished, you can see visual improvment and, above all after a few hours, when the effect of the drops that dilate the pupil starts to wear off. The only thing that a patient might notice is floaters over the first few days, but it is temporary.
Why does the posterior capsule become opaque after cataract surgery?
After cataract surgery, there are always some epithelial cells leftover in the crystalline lens within the capsular bag despite exhaustive cleaning which is done to try leave it more transparent upon the finishing the surgical procedure. Over time, these cells multiply and migrate towards the posterior capsule provoking the opacification thereof. On the other hand, the design of certain intraocular lenses may influence the migration of the epithelial cells inside the capsular bag, which is why we must take this detail into account when it comes to choosing the intraocular lens model to be implanted.