After cataract surgery, the cataract will never come back. However there is about a 50/50 chance that a protein film will form across the posterior capsule. This protein material is generated from microscopic cells that cling to the anterior capsule and the equator of the natural lens which became a cataract.
During cataract surgery it is impossible to remove every cell because of their microscopic size and location. After cataract surgery these cells continue to produce the same protein material that they did before cataract surgery even though the lens is now gone. In about 50% of patients the film will migrate across the posterior capsule creating what eye doctors refer to as “capsule clouding” or “Posterior capsule opacification (PCO)”. This process usually takes a year or two to cause visual blurring, but it has been seen as early as three weeks following cataract surgery. It is easily corrected with the YAG laser.
The YAG (Yttrium-Aluminum Garnet) laser uses laser light in a focused beam to make small openings in the posterior capsule to clear the clouded membrane. No anesthetic is required since the capsule has no nerve endings and therefore there is no pain, just like hair or finger nails can be cut without pain. How does the laser pass through the cornea (the clear front window of the eye) without damaging it? The laser is a “focused” beam of light and only affects the tissue that it is focused on. An example of focused light would be holding a magnifying glass to focus sunlight on a piece of paper to burn it. For this reason patients can blink during the treatment without any harm to their lids or other eye structures. In this way the YAG laser clears the membrane and takes away any frame work for the protein to build on. The protein material can continue to form in the periphery (called Elshnig pearls) where in most cases vision is not interfered with but the visual axis or line of sight remains clear. So, once the capsule clouding is cleared it is usually permanent.See Also Cataract Removal
Common Questions about YAG Laser Procedure
Q: Why Do I need this procedure?
A: After cataract surgery, there is a 50/50 chance that a protein film will form across the posterior capsule. This protein material is generated from microscopic cells that cling to the anterior capsule and the equator of the natural lens which became a cataract. It is almost impossible to vacuum every remaining cell at the time of surgery. The cells left behind will continue to produce protein. This is called capsule clouding.
Q: What is a YAG Laser Capsulotomy?
A: A YAG Laser Capsulotomy is a laser procedure where the eye(s) is dilated, giving the doctor a view of the protein buildup behind the implanted lens. The YAG laser clears protein film to restore vision.
Q: Is the YAG Laser Capsulotomy done just like cataract surgery?
A: No. This procedure only takes 1-2 minutes of treatment for your eye(s). There is no pain involved since nothing will touch your eye(s). You will sit behind the YAG laser (which looks like a microscope) and will look where the doctor tells you. On average, about 50 pulses from the laser will be used to treat your eye. Once the procedure is complete, it should not have to be repeated again in the future.
Q: What if I blink during the procedure?
A: It's okay to blink during the procedure. The laser has a focused beam of light that only affects the tissue that it is focused on, with no harm to your lids or other eye structures. No lid holding device is required.
Q: What does YAG stand for?
A: YAG stands for Yttrium, Aluminum and Garnet crystals used to generate the laser.
Q: Are there any restrictions before or after my procedure?
A: No. You may go about your daily routine, take your medication(s) as directed and you can eat your normal meal(s) before your procedure. There are no eye drops you need to take, but if you take eye drops for other reasons you may continue to do so. You will notice that your vision may be blurry for a few hours due to your eye(s) being dilated and you may notice new floaters in your field of vision (this will eventually decrease over a period of time). These floaters never actually go away, but they do gradually settle down by gravity over a few months.
Q: Will I need a new glasses prescription after this procedure?
A: When you go into your follow-up appointment, your doctor will recheck your prescription and change it at that time if needed.