YAG Laser Capsulotomy: PCO Treatment, Risks & Recovery

Posterior capsule opacification (PCO) is a relatively common occurrence after cataract surgery but is easily treatable. Sometimes you can develop a thickening of the back (posterior) of the lens capsule which holds your artificial lens in place. Thickening of the capsule means that light is less able to travel through to the retina (the light-sensitive layer at the back of your eye). Sight can become cloudy or blurred, or you may have problems with bright lights and glare. Current studies show that this can occur in 10–20% of patients at any time after cataract surgery.

If this happens, you may need to have laser treatment to make your vision clear again.

WHAT DOES THE PROCEDURE INVOLVE?

The procedure is done by making a gap in part of the back of your lens capsule using a YAG laser, so that light can once again pass directly to the retina. For the vast majority of people this can improve vision. This type of laser is safe and has very few complications.

WHAT HAPPENS BEFORE THE LASER TREATMENT?

A member of Mr. Bhalla's team will check your vision and measure your intraocular pressure. Drops will be instilled to dilate the pupil; these can take up to 30 minutes to work. The retina at the back of the eye will be examined to ensure that there are no other problems.

Mr. Bhalla will discuss the benefits and possible complications of the treatment with you prior to you signing the consent form. The procedure itself only takes about five to ten minutes, but due to the various tests needed, please allow up to two hours for your appointment.

HOW IS THE LASER TREATMENT CARRIED OUT?

The laser treatment is painless and is carried out while you are seated at a machine similar to the one used to examine your eyes in clinic. Local anaesthetic drops will be given and a contact lens may be placed on your eye to steady it and focus the laser beam.

The laser light is invisible, but a bright light is used so that the capsule can be seen clearly. Each laser shot lasts a fraction of a second and you will hear a loud clicking sound at the same time.

WHAT HAPPENS AFTER THE LASER TREATMENT?

The laser creates a hole in the opaque membrane behind the implant, allowing light to reach the retina and restoring vision to the level it was before the membrane became cloudy. It may take several days before your vision is fully restored. Mr. Bhalla's team may give you drops to use after the procedure.

You are advised not to drive yourself home after your procedure, as it can take some time for the dilating drops to wear off and your vision may still be blurry following the laser. Please ensure that you make other travel arrangements.

Because the laser treatment does not require any incisions or stitches, you are normally able to return to your daily activities straight away

WHAT ARE THE RISKS OF THE LASER TREATMENT?

The laser procedure is considered very safe. Though there are some risks, serious side effects are very rare.

If a contact lens is used, your eye may be a little sore following the treatment, but this should soon wear off.

Common complications:

Raised eye pressure: For some people, laser treatment for PCO can cause eye pressure to briefly rise. If Mr. Bhalla is concerned about this, a member of Mr. Bhalla's team will check your eye pressure soon after the laser treatment. If your eye pressure has increased, you will be provided with eye drops or a tablet to bring it back down.

Inflammation inside the eye:This is uncommon and responds rapidly to anti-inflammatory drops.

Floaters: These are harmless clumps of cells which move around inside the vitreous (a jelly-like substance which fills the inside of the eye). You may see floaters as dots, circles, lines, clouds or cobwebs.

Rare but serious complications:

Retinal damage: Rarely, the laser can cause a retinal detachment, which can happen days, weeks or months after the treatment. This is more likely to occur if you are very short-sighted. It is important to stress that this is an extremely rare complication. Mr. Bhalla will discuss the symptoms of retinal detachment with you. Please also be aware that retinal detachment surgery is normally very successful in preserving or restoring good vision.

Damage to the intraocular lens: Minor scratches are occasionally unavoidable but very rarely cause visual problems.

The vast majority of people get an excellent improvement in their vision following YAG laser without experiencing any issues.

WHAT IF I HAVE A PROBLEM WHEN I GET HOME?

Please contact Mr. Bhalla's team promptly if you experience any of the following:

Pain not relieved by your normal painkillers

Noticeable redness in your eye

Your sight becoming worse

Flashing lights or a shadow/curtain in your vision