YAG Capsulotomy Procedure
A YAG laser is the most commonly used type of laser. It was developed in the 1970s by Drs. Aron-Rosa and Frankhauser. YAG is an acronym for yttrium aluminum Garnet, a synthetic garnet that is used as the lens for the laser. When the laser beam is generated, it’s controlled by a foot pump, which makes it very easy to focus and manipulate.
Dr. Aron-Rosa had a background in physics before becoming an ophthalmologist, and she was very interested in ruby lasers, which were the standard of the time. She realized that the ruby laser had too slow a pulse for the purpose she intended, which was to disrupt the tissue in a very small and focused area of the eye.
Dr. Aron-Rosa performed the YAG Capsulotomy procedure more than 5,000 times in clinical trials over four years. She applied for a patent in 1978. Dr. Frankhauser used the YAG laser for the first time in 1980. Once in general use, it caught on very quickly, because the alternative surgery was much more invasive, and had a longer recovery period.
The YAG Laser Today
The YAG laser is used today for many different applications, from medical to industrial. It’s designed to be a very precise instrument for very fine work, which is why it’s so widely used for eye surgery. Other uses for this type of laser are hair removal, dermatology procedures, and engraving on cloth or leather. One of the surgical uses for the YAG laser is for capsulotomy after cataract surgery.
Other uses include:
- Skin resurfacing
- Spider vein removal
- Mole or freckle removal
- Laser vitreolysis (removal of floaters)
- Skin tightening
- Removal of acne scars
- Tattoo removal
If you’ve had cataract surgery and developed an opacification (cloudiness) as a result, the YAG laser can be used to remove the cloudiness. Cloudiness that lingers after your eye surgery is the result of your eye trying to regrow a new lens from remaining lens material.
The lens of your eye has a lining that’s called the capsule. It’s like cellophane. When you have cataract surgery, your surgeon leaves the posterior part of the natural lens in place to help hold the new implant. This lens is normally clear, but often the membrane becomes cloudy or wrinkled over time. This can occur months or years after the original cataract surgery. Most patients have this happen within five years.
When Capsulotomy Is Necessary
Three out of four people who have cataract surgery develop this condition and need to have the secondary procedure done. The development of cloudiness can be more common if surgery is done at younger age, and even more frequently if it’s a pediatric case.
Your ophthalmologist performs a procedure called a posterior capsulotomy to remove the layer of new cells. This is different from an anterior capsulotomy that the surgeon does when removing your cataract and implanting a new lens in your eye. In the case of the posterior capsulotomy, the ophthalmologist uses the laser wavelength to weaken the layer of cloudiness, and form a hole. Once the hole is created, normal vision is restored. This is a painless operation that takes just a few minutes.
The Actual Surgery
If you develop any of these issues at any time after your cataract surgery, see your ophthalmologist for a complete exam:
- Problems with daily activities such as reading or driving
- Decrease in visual acuity
- Increased glare
An hour before your procedure, your doctor puts a pressure-lowering drop in your eye. He also applies a drop to dilate your pupil. Sometimes a local anesthetizing drop is used as well. Once in the surgical room, you place your head on the chinrest of a slit lamp microscope with the laser attached.
A strap is used to keep your head still during the few minutes that it takes your ophthalmologist to use the laser. The operation should be completely painless. When done, the doctor puts another drop of pressure-lowering medication into your eye.
YAG Procedure Recovery
The recovery period from a YAG Capsulotomy procedure is quite short. It’s an outpatient surgery, and you can go home as soon as the doctor is sure everything went as planned. Usually, it takes one to four hours for the pressure in your eye to normalize.
You can resume normal activities, including driving, once you’re home. If your eye pressure is still elevated, drops to lower the pressure may be prescribed for a week following the procedure. Sometimes, drops to prevent muscle spasms and or steroid drops to reduce inflammation may be used as well. You’ll need follow-up visits one day, one week and six months afterward.
There are some risks associated with this procedure. It’s possible that the laser could damage your intraocular implant. This could happen due to the heat of the laser, the amount of energy used and/or the accuracy of your eye surgeon. The more opaque the lens, the more energy is needed to remove it. When the lens is less opaque, it’s easier for the surgeon to be more accurate.
Another problem could occur if the replacement lens is displaced by the laser during the procedure. Sometimes, a second capsulotomy is required if the opening created from the first one begins to grow tissue again and close the hole. Other, less common risks include:
- Macular edema, swelling of the macula
- Macular holes
- Corneal edema
- Inflammation of the iris
- Retinal detachment
- Increased ocular pressure
- Glaucoma caused by the increased ocular pressure
- Increased glare at night, which happens when the size of the hole made by the procedure is smaller than the size of the pupil in the dark
After surgery, your vision may be blurry for a while. As your eye heals, it changes shape. It’s best to wait at least six weeks before getting a new prescription for eyeglasses. You may notice colors are very bright or things have a reddish tinge. This goes away within a few months. This occurs because your lens is now clear. Your doctor will let you know when it’s safe for you to resume driving.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.
Do you have any questions about YAG Capsulotomy Procedure in NYC? Would like to schedule an appointment with the leading Ophthalmologist in New York, Optometrist Dr. Saba Khodadadian of Manhattan Eye Specialists, please contact our office for consultation with New York eye doctor.
Dr. Saba Khodadadian, Optometrist (NYC Eye Doctor)
New York, NY 10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4821