YAG Laser Treatment

A cataract is the clouding of the natural human lens. The human lens is encased by a delicate clear membrane called the "capsule". With modern microincision cataract surgery, a round opening is made in the front of the capsule and the cataract is removed through this opening. The back portion of the capsule (known as the posterior capsule) is left in place and used to fixate the intraocular lens in the same location as the natural lens. This membrane, referred to as the posterior capsule, is usually initially clear and transparent like saran wrap.

It is not uncommon after cataract surgery for this initially clear posterior capsule to become cloudy months to years after the surgery. Many patients will never develop this clouding and will never need a YAG Laser. It is more likely to develop in young patients and following the removal of certain type of cataracts. Like a healing response, the tendency for the capsule to later cloud varies with the individual. The intraocular lens implant that Drs. Solway and Rasansky utilize has been shown to decrease frequency of this membrane becoming cloudy and subsequently the need for a YAG Laser treatment.

If your posterior capsule becomes cloudy it will cause a progressive reduction in vision and can mimic a lot of the symptoms you had initially with your cataract (blurred vision, halos, etc). When the posterior capsule becomes so cloudy that it is affecting your vision, a YAG Laser treatment is usually recommended. In the past, the membrane had to be opened with a knife and there were significant risks since the eye was opened. However, with the advent of the YAG Laser treatment the risks have been significantly reduced.

The microscopic light beam of the YAG laser is focused through the transparent cornea onto the cloudy membrane. The laser than creates an opening in the central aspect of the cloudy membrane. Once the opening is created by the laser, it will remain open and should not need to be repeated. There is no potential for infection or wound complications, and no need for reduced physical activities after the laser procedure.

The procedure is performed on an outpatient basis at the Baptist Medical Park ASC. There is no need to change clothing, and there are no restrictions on diet, exercise, reading, or TV following the treatment. Your regular medications, such as pills or eye drops, should be taken at your normal times.

You will be seated at the laser and a special focusing lens will be placed on your eye to prevent the lids from closing and to improve visualization of your cloudy membrane. There is no pain involved during the procedure. You will hear a clicking noise and see a red light. The clicks represent the microscopic laser applications used to create the opening in the cloudy posterior capsule. Since the capsule is naturally on stretch, each microscopic laser application will result in a progressively larger opening until the optimal size opening is attained.

Yag LaserFollowing the treatment, there may be a temporary blurring for the rest of the day. The eye may be slightly irritated that day as well. Usually by the next day the eye feels normal and the vision is improved back to the level it was prior to the membrane becoming cloudy.

As with any procedures there are risks. Fortunately, with the utilization of the laser many of the previous risks, such as infection and bleeding have been eliminated. There is a rare incidence of retinal detachments after the YAG Laser treatment. This is extremely rare and occurs in approximately 1 out of every 1000 cases. In addition, the YAG Laser treatment has been associated with swelling in the retina (cystoid macular edema) in approximately 1 out of every 1000 cases. Both these problems occur independently as a result of aging and it has not been proven with certainly there is a cause and effect relationship. In addition, small temporary floaters may appear immediately following the laser treatment. These are microscopic particles from the capsule, and will eventually float away. They are separate from the permanent floaters in the vitreous gel that some patient's develop as a function of age.

Drs. Solway and Rasansky will discuss with you the risks and benefits of the YAG Laser procedure as it applies to your particular situation.