The aim of this information sheet is to answer some of the questions you may have about having a Yag
laser capsulotomy. It explains the benefits, risks and alternatives of the procedure as well as what you
can expect when you come to hospital.
What is a Yag laser capsulotomy? A Yag capsulotomy is a special laser treatment used to improve
your vision after cataract surgery. It is a simple, commonly performed procedure which is very safe.
During your cataract operation, the natural lens inside your eye that had become cloudy was removed. A
new plastic lens was put inside the lens membrane (called the bag or capsule) in your eye. In a small
number of patients, the capsule thickens after surgery and becomes cloudy. This interferes with the light
reaching the back of the eye. When this happens, your sight becomes misty, and you may get glare in
bright light or from lights at night-time. Capsule thickening can happen in the months after your cataract
operation, but more commonly occurs about two years after surgery. Yag laser capsulotomy is the only
way to treat this. Apart from affecting your vision, the thickening does not damage the eye in any way.
In a Yag laser capsulotomy the doctor uses a special lens to apply a laser beam to the capsule. This
creates a small hole in the centre of the capsule, which lets light through.
What happens during a Yag laser capsulotomy? Special preparations such as fasting or changing
into operating theatre clothes are not necessary. You will have some drops put into your eye to make the
pupil big, and an anaesthetic eye drop to numb the surface of the eye. You will then sit at a machine –
similar to the one used to examine your eyes when you routinely visit the eye clinic – which has a special
laser attached. The doctor will put a special mirrored lens on your eye before applying the laser beam.
This lens allows the doctor to view the membrane clearly so he or she can apply the laser and make a
small hole in it to clear the vision. The treatment is painless due to the anaesthetic drops used to numb
your eye before the laser and takes approximately 20 minutes. After the procedure, you will return to the
waiting area. Your doctor or nurse may check the eye pressure about one hour later. He or she will then
examine the eye to check the hole in the capsule.
What are the benefits? The laser treatment is to remove the cloudy capsule thickening in your eye,
which aims to restore your vision to how it was after your cataract operation.
Are there any risks? Complications after this treatment are very uncommon. Occasionally the pressure
inside the eye rises immediately after the laser treatment. If this occurs, you may need extra treatment
before you can go home. This treatment usually comes in the form of eye drops, but may come in the
form of tablets. Your doctor will let you know which treatment you need and advise you of how long you
need to take the treatment for. If we do treat you with eye drops, a doctor or nurse will put then in your
eye before you leave hospital. You will be asked to remain in the department until your eye pressure has
lowered to a satisfactory level. This should take a few hours at most. Occasionally the opening made by
the laser beam is incomplete, or not big enough. This will be discovered either after your treatment, or
on your follow-up visit. If this is the case, it will be necessary to repeat the treatment at a later date.
Extremely rarely, some patients can get a build- up of fluid in the macula, the part of the eye responsible
for detailed central vision. This build-up of fluid is called macular oedema (swelling), which causes
blurring or distortion of vision. Another extremely rare complication is retinal detachment, when the fine
light sensitive membrane at the back of the eye can come away from the wall of the eye. The following
symptoms mean that you need urgent treatment: excessive pain , sudden onset, of floaters (caused by
small pieces of debris that float in the vitreous humour of the eye), loss of vision, flashing lights,
increasing redness of the eye. If you experience any of these symptoms, telephone the Ridley
Clinic for advice immediately, or visit your nearest accident and
emergency department.
Are there any alternatives? An alternative to a Yag laser capsulotomy is to do nothing. The capsule
may or may not continue to thicken. If it does, you may wish to consider a Yag laser capsulotomy at a
later date.
What do I need to do to prepare? Since this is an outpatient treatment, you can eat and drink as
normal. You must continue to take any eye medication as normal on the day of the laser treatment
(unless instructed otherwise). Asking for your consent We want to involve you in decisions about your
care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that
you agree to have the treatment and you understand what it involves. If you would like more information
about our consent process, please speak to a member of staff caring for you. No treatment is carried out
without your consent unless it is an emergency and you are unconscious.
What happens after the procedure? After the treatment, most patients find that their vision is
usually blurry for four hours from the drops. Bright lights can also be bothersome. Because of this, it can
be helpful to have someone to go home with you, but this is not essential. You should not drive or ride a
motorbike or bicycle for the rest of the day. Following the procedure, no special treatment is required,
and you can go back to your normal daily activities straight away. If you have discomfort once you have
returned home, we suggest that you take your usual pain reliever following the instructions on the pack.
It is normal to have itchy, gritty or sticky eyes and mild discomfort for the remainder of the day after the
treatment. You will be asked to come to the outpatient department a few weeks after the laser treatment
to make sure your eye has settled down properly. This appointment will be given to you before you leave
the hospital.
What do I need to do after I go home? Anti-inflammatory drops may be prescribed after the laser
treatment. These help to minimise inflammation (not infection) within the eye. People normally have to
take these only for a few days or a week at most – your doctor will tell you how long you need to use
them for. You do not need antibiotics, as there is no open wound on your eye.