YAG Laser
If you have had a cataract operation, a clear plastic lens is placed in the 'bag' left behind when the cataract is removed. The new lens focuses the light onto the back of the eye, just like the original human lens. The 'bag' is called a capsule: the capsule supports the implant.
This capsule is normally clear like a glass window. It is very thin, like cellophane. In a some of patients the capsule thickens up, and becomes a little opaque, like a frosted glass window. This stops the light reaching the back of the eye. If this happens, your sight become misty, and it can become difficult to see at night, or in sunlight.
Capsule thickening can happen in the months after your cataract operation, but more commonly occurs two or three years after. The capsule thickening does not damage the eye in any way; it merely makes the sight fuzzy. Although some people call this condition a "secondary cataract," it is not really a cataract. Once a catraact is removed, it does not come back.
Laser treatment makes a small hole in the centre of the capsule, and can restore your vision to how it was after the cataract operation. The treatment does not hurt, and you hardly notice anything at all. It takes about fifteen minutes; the laser machine is in the outpatient clinic.
To carry out the laser, the front of your eye is anaesthetised with an anaesthetic drop, and a small contact lens is placed on your eye. Placing your head on the frame of the laser machine to keep your eye still, the surgeon focuses the laser on the capsule.
The laser then makes small holes in the capsule, often in a circle. The holes join up and, like tearing a postage stamp, a small hole is made in the capsule. The capsule segment drops to the bottom of the eye (over minutes or hours).
After Laser
For a few days after the laser you may notice a lot of floaters. The capsule segment drops to the bottom of the eye over a few days, and is normally not very noticeable. You may notice large or small floaters at this time.
Are there any complications?
The laser is considered very safe, with very few complications. Occasionally a little more laser is need to release the capsule on a second occasion. Only a small opening is needed, so the lens implant still has enough support.
Very uncommonly, the laser can disturb the retina. A little fluid can build up in the central part of the retina, termed cystiod macular oedema, this will often resove on it's own, or can be treated with additional medication.
Also very occasionally the laser can disturb the retina, damaging it a little months years later. If this happens and makes a tiny tear in the retina, you may notice
- flashes of light during the daytime
- floaters in your vision (it is normal to have these in the weeks after the laser)
- a 'curtain' drifting across your vision
If you notice a lot of flashes and floaters all of a sudden, you need to have your eye examined to check if there is a small tear in the retina.
Other complications are very unusual.