Yag capsulotomy: Posterior capsule opacification

What is posterior capsule opacification?

Posterior capsule opacification is a clouding of the lens capsule that can occur months to years after a cataract surgery. During cataract surgery the eye lens is removed and is replaced with an artificial lens. Sometimes new lens fibers can grow over the posterior of the lens capsule causing a clouding of the lens capsule, which we call posterior capsule opacification. After cataract surgery, 1 out of 3 patients develops posterior capsule opacification within 5 years. It is therefore a very common phenomenon that is luckily very easy to treat.

Symptoms

Patients who have posterior capsule opacification usually consult their ophthalmologist due to blurry vision as though they are looking through frosted glass. Visual acuity at distances (for example watching television, recognizing faces) and up close (for example reading, sewing) are increasingly difficult.

Treatment

Posterior capsule opacification can be treated at the Eye Clinic in Winksele with an eye laser treatment using the yag laser. This operation takes place during the consultation. This eye laser treatment is very different from the eye laser treatment used to see without glasses or contact lenses.

Yag

For this eye laser treatment, the pupils are dilated with eye drops. To do this, you need to arrive at least 15 minutes prior to the treatment. After 15 minutes the cornea of the eye is numbed with eye drops. You will sit on a stool behind the laser device with your chin and forehead placed against the support. During this treatment a glass contact lens is placed on the cornea. You will not feel this lens because the cornea has been numbed. This lens focuses the laser beams on the cloudy lens capsule. An opening is made on the cloudy central part of the posterior lens capsule.

This eye laser treatment is painless and takes approximately 10 minutes.

After the eye laser treatment

Immediately after the eye laser treatment, you will usually see less clearly as a result of the pupil dilating eye drops and the gel that was used. This is why it is sensible to not drive yourself after this treatment, and is best to arrange for someone who can take you to and from the Eye Clinic.

Risks

The risks from eye laser treatment for posterior capsule opacification are minimal. Occasionally there is a minor inflammatory reaction in the eye. In order to suppress this inflammatory reaction, you are instructed to use anti-inflammatory eye drops for one week. There are often floaters in the eye after this eye laser treatment. These usually go away on their own.

Yag-laser iridotomy: acute glaucoma

When is this eye laser treatment necessary?

Yag-laser iridotomy is an eye laser treatment that is performed in the Eye Clinic in Winksele in case of a narrow or closed anterior chamber

The front of the eye is filled with aqueous humor that is made by the ciliary body behind the pupil. This moisture has to leave the eye via drainage canals in a little area at the front of the eye: the anterior chamber angle. In this way the moisture returns to the bloodstream.

The anterior chamber angle needs to be sufficiently wide open in order to allow the aqueous humor through. If this angle is too narrow (narrow angle glaucoma) then the fluid cannot sufficiently drain from the eye, potentially resulting in increased eye pressure. A sudden closure of this anterior chamber angle (acute angle-closure glaucoma) will cause a very sudden increase in eye pressure: this is called an acute angle-closure glaucoma attack.

The aim of the laser treatment

An opening is made in the iris with the yag laser. Through this opening the aqueous humor can easily flow from the posterior chamber, where it is made, toward the anterior chamber where drainage happens.

Preparation for the eye laser treatment

Firstly, for this treatment eye drops are applied in order to constrict the pupil. For this reason, you will need to arrive 15 minutes prior to the treatment at the Eye Clinic in Winksele. After 15 minutes, the cornea of the eye is numbed with eye drops.

Procedure of the eye laser treatment

You will sit on a stool behind the laser device with your chin and forehead placed against the support. During this treatment a glass contact lens is placed on the cornea. You will not feel this lens because the cornea has been numbed. This lens focuses the laser beams on the peripheral area of the iris in order to make a very small opening. You may feel small jabs during this eye laser treatment, but it is not usually painful. The treatment usually only lasts for a few minutes.

After the eye laser treatment

Immediately after the eye laser treatment, you will usually see less clearly as a result of the pupil still being constricted and the gel that was used. This is why it is sensible to not drive yourself after this treatment, and is best to arrange for someone who can take you to and from the Eye Clinic.

Risks

The risks from eye laser treatment for iridotomy are minimal. Occasionally there is a minor inflammatory reaction in the eye. In order to suppress this inflammatory reaction, you are instructed to use anti-inflammatory eye drops for one week.


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