Posted - February 21, 2022

Posterior Capsule Opacification (PCO) & YAG Laser

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Posterior capsulotomy is a painless laser procedure you may need after cataract surgery to restore clear vision. This procedure is needed in about 30% of cases and is not due to anything you or your surgeon did. When your new lens was implanted in your eye during cataract surgery, it was placed in the eye’s natural capsule. Over time, there is a chance this capsule can become cloudy and wrinkled on its own, causing blurry vision. Your ophthalmologist will use a YAG laser in the clinic to make an opening in the cloudy capsule, allowing light to pass through properly again.


What is posterior capsulotomy?

Posterior capsulotomy is laser surgery you might need sometime after cataract surgery. It helps you see clearly if your vision becomes cloudy again. When you have cataract surgery, your ophthalmologist removes your eye’s cloudy lens. They replace it with a clear, artificial intraocular lens (IOL). The IOL is held in place in the eye’s natural lens capsule. Weeks, months or years later, in some cases, this capsule can become cloudy or wrinkled, causing blurry vision. It is nothing the surgeon or the patient has done and naturally can happen with healing. With posterior capsulotomy, a YAG laser is used to make an opening in the cloudy capsule. Once done, it never has to be repeated. This allows light to pass through again for clear vision.


What happens during posterior capsulotomy?

The procedure is done in your ophthalmologist’s office. It only takes about 5 minutes. You will be given an eye drop to dilate your pupil. Your ophthalmologist will use a machine that looks like a regular exam microscope used to look at your eyes. The doctor then points a special laser at the back of the lens capsule and make a small opening. It is painless. After the procedure, usually you can do all your normal daily activities, including driving. Your ophthalmologist will tell you if there are things you should not do right after surgery. If you have no other eye problems affecting your vision, your sight should improve in about 24-48 hours. Continue all regular drops.


What are the risks of posterior capsulotomy?

As with any surgery, there are possible risks and complications with posterior capsulotomy.

  • The most common side effect is floaters. 80% of the time, they resolve. However, there is a risk of having permanent new floaters.
  • Other serious risk, even though very low chance, is a detached retina (where the tissue lifts from the back of your eye). You may see what looks like a gray curtain moving across your field of vision. You should call your ophthalmologist immediately if this happens to your vision.
  • The pressure in your eye may increase.
  • The IOL might move through the posterior capsule opening.
  • You may have swelling in your eye, and you may need steroid eye drops.

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