YAG laser treatment for posterior capsule opacification (PCO)

What is Posterior capsule opacification (PCO)?

Posterior capsule opacification (PCO) is a relatively common occurrence after cataract surgery but is easily treatable. Sometimes you can develop a thickening of the back (posterior) of the lens capsule which holds your artificial lens in place. Thickening of the capsule means that light is less able to travel through to the retina (the light sensitive layer at the back of your eye). Sight can become cloudy or blurred or you may have problems with bright lights and glare. Current studies show us that this can occur between 10-20 % of patients at any time after surgery.

If this happens you may need to have laser treatment to make vision clear again. This type of laser is safe and has very few complications. The procedure is done by making a gap in part of the back of your lens capsule using a YAG laser, so that the light can once again pass directly to the retina. For the vast majority of people this can improve vision.

What happens before YAG laser treatment?

Your vision will be checked, and your intra-ocular pressure measured. Drops are instilled to dilate the pupil; these can take up to 30 minutes to work. The retina at the back of the eye is examined to ensure that there are no other problems. The benefits as well as possible complications of the treatment will be discussed with you prior to you signing the consent form. The procedure only takes about five to ten minutes, but due to the various tests needed please expect to be in hospital for up to two hours.

How is the YAG laser treatment carried out?

The laser treatment is painless and is carried out while sitting at a machine similar to the one you were examined with in the clinic. Local anaesthetic drops will be given and a contact lens may be placed on your eye to steady it and focus the laser beam. The laser light is invisible but a bright light is used so that the capsule can be seen. Each laser shot lasts a fraction of a second and you will hear a loud clicking sound at the same time.

What happens after YAG laser treatment?

The laser cuts a hole in the opaque membrane behind the implant. This allows light to reach the retina, therefore bringing vision back to the level it was before the membrane became cloudy. It may take several days before your vision is fully restored. Drops may be given for you to use after the procedure.

We advise that you do not drive yourself home after your procedure as it can take some time for the drops that dilate your pupils to wear off, and your vision may still be blurry following the laser. Please ensure that you make other travel arrangements. Because the laser treatment does not require any incisions or stitches, you are normally able to return to your daily activities straight away.

What are the risks of YAG laser treatment?

The laser procedure is considered very safe. Though there are some risks, serious side effects are very rare. If a contact lens is used, your eye may be a little sore following the treatment, but this should soon wear off.

Common complications 

  • For some people laser treatment for PCO can cause eye pressure to briefly rise. If your doctor is concerned about this they will check your eye pressure soon after the laser treatment. If your eye pressure has increased, you will be provided with some eye drops or a tablet to bring it back down.
  • Inflammation inside the eye: this is uncommon and responds rapidly to anti-inflammatory drops.
  • Floaters: these are harmless clumps of cells which move around inside the vitreous (a jellylike substance which fills the inside of the eye). You may see floaters as dots, circles, lines, clouds or cobwebs.

Rare but serious complications

  • Retinal damage: rarely, laser can cause a retinal detachment which can happen days, weeks or months after the treatment. This is more likely to happen if you are very shortsighted. It is important to stress that these risks are extremely rare complications of the laser treatment. The vast majority of people get an excellent improvement in their vision following laser without experiencing any issues. If you have any concerns, the clinician performing the procedure will discuss this with you and will also describe the symptoms of retinal detachment. Please also be aware that retinal detachment surgery is normally very successful in preserving or restoring good vision.
  • Damage to the intraocular lens: minor scratches are occasionally unavoidable but very rarely cause visual problems.

What if I have a problem when I get home?

Please contact your clinical team if you experience any of the following:

  • pain not relieved by your normal painkillers.
  • noticeable redness in your eye.
  • your sight becoming worse.
  • flashing lights or a shadow/curtain in your vison.

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0800 328 3421

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