Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy is a relatively non-invasive procedure that is used in the treatment of posterior capsular opacification in the eye. The procedure is performed by an ophthalmologist (eye surgeon). It is a short procedure, performed under local anesthesia, and on an out-patient basis.
One of the most common long-term complications after cataract surgery is the clouding of the membrane around the lens. The membrane is called the posterior capsule. When the posterior capsule becomes opacified, the condition is called posterior capsule opacification. This condition presents with symptoms such as decreased vision, glare, and other symptoms similar to other cataract symptoms. The opacification occurs due to the proliferation of epithelial cells in the lens leading to fibrosis and wrinkling of the posterior capsule. The posterior capsular opacification can be easily treated with YAG laser.
Indications for YAG laser capsulotomy:
- Lens opacification interfering with daily activities
- Decreased vision
- Increased glare
- Difficulty in visualizing posterior structures of the eye, such as the fundus on eye examination by the doctor
When should YAG laser capsulotomy not be done?
There are no absolute reasons for the procedure not to be done. Some relative contraindications for Nd:YAG laser capsulotomies include the following:
- Corneal scarring or swelling that prevents a clear view during the procedure
- Placement of a glass intraocular lens during cataract surgery
- Iritis (inflammation of the iris, the pigmented disc in the eye)
- Swelling (edema) of the retina
- History of retinal tears or detachments
- Recent history of eye surgery
- Patients with increased eye pressure
How is YAG laser capsulotomy performed?
The procedure is performed under local anesthesia. Topical anesthesia (anesthetic eye drops) can be used to perform Nd: YAG without any significant pain or discomfort. The patient is made to sit at a slit lamp equipped with a YAG laser.
Nd: YAG laser beams are applied in rapid busts and the opacified spots in the capsule are burnt away. This creates a small circular opening in the membrane that previously hampered your vision. The procedure can be done in an outpatient setting and only takes a few minutes.
After the procedure:
Topical steroids may be prescribed to reduce inflammation. Regular follow-up is advised.
The procedure usually does not need to be repeated unless the posterior capsule was not completely burnt away.
What are the complications of YAG laser capsulotomy?
The procedure is relatively safe. Some possible complications may include:
- Increased pressure inside the eye (elevated intraocular pressure)
- Iritis (inflammation of the iris)
- Retinal tears
- Retinal detachment
- Corneal swelling (edema)
- Swelling of the posterior structures of the eye
- Intraocular lens dislocation
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