Lasers have transformed the field of ophthalmology, making treatments less invasive and more effective, and delivering treatment options where previously there may have been none. Different lasers are employed for the treatment of many eye conditions, including cataracts, refractive errors, and more. One laser, called YAG or yttrium aluminum garnet, uses a specific wavelength of light to breakup different cells without interfering with nearby structures. In ophthalmology, YAG laser treatment is used to treat posterior capsule opacification (PCO), restoring clear vision after complications arising from cataract surgery.
What is a Yag Laser Treatment
The YAG laser treats PCO following cataract surgery. PCO occurs when the cells in the eye migrate into the lens capsule, forming a cloudy layer on the back of the capsule which obscures vision and feels like a second cataract to the patient. It is a fairly common in the side effects of cataract surgery, and a YAG capsulotomy allows for a simple, fast solution to a life-altering problem. In one study performed across 10 states, the YAG procedure resulted in 99% of patients reporting improvements in visual acuity following the procedure. This is great news for people that have undergone cataract surgery and are suffering from cloudy vision for a second time!
Symptoms or Signs of Secondary Cataracts
Secondary cataracts may develop after months, or even years, of clear vision following cataract surgery. However, there are clear signs and symptoms that you may be developing a secondary cataract and need treatment for cloudy vision after cataract surgery, including:
- Gradual cloudy vision – At first, the cells collecting on the lens may not produce any symptoms or changes in vision, however, as they proliferate, your vision may become more and more foggy.
- Increased glare and light sensitivity – Following cataract surgery, you may have experienced similar side effects, but they should have resolved. If glares or a sensitivity to light have increased or come back, it may indicate the development of secondary cataracts.
- Difficulty with details or reading – Even with your glasses, it may be more and more difficult to read or perform detailed work as PCO progresses.
- Reduced contrast sensitivity – Another telling symptom is the inability to distinguish between different shades of colors or colors appearing less vibrant.
If you suspect secondary cataracts, the problem needs to be fixed by an ophthalmologist with the YAG procedure. However, there are things you can do at home to make yourself more comfortable before the procedure, including adjusting the brightness of lights, wearing sunglasses when outdoors, and getting a new glasses prescription.
Symptoms That Are Not Related to Secondary Cataracts
Some symptoms may indicate a more serious condition and should be reviewed by an ophthalmologist as soon as possible. Those symptoms include:
- A sudden loss of vision
- Eye pain or severe discomfort
- Red, swollen, or seeping eyes
- Double vision in one eye or distorted vision
Causes of Secondary Cataracts
The leading cause of secondary cataracts stems from the natural healing process following cataract surgery. During cataract surgery, the cataract is broken up and removed with the lens capsule left intact so it can hold the new IOL which allows the patient to see clearly. However, some residual lens epithelial cells may get left behind, even when the lens capsule is cleaned before placing the IOL.
Unfortunately, these remaining cells can undergo transformation into two problematic cell types:
- Fibrous Metaplasia: Some epithelial cells transform into fibrous tissue, creating scar-like formations that can cause wrinkling or contraction of the posterior capsule.
- Elschnig Pearls: Other cells may develop into pearl-like formations called Elschnig pearls, which are bladder cells that can proliferate and migrate across the posterior capsule, creating cloudiness.
Both of these cellular changes can occur months to years after the initial cataract surgery, which is why patients will notice a gradual worsening of symptoms.
While there is no way to prevent PCO from happening, there are risk factors that make certain patients more likely to develop the condition, such as:
- Age – Younger patients may have more active cells, meaning the cells are more likely to migrate and change.
- Patients’ healing ability – Patients with pre-existing conditions or those whose cellular activity is higher may be at increased risk for the condition.
What Does NOT Cause Secondary Cataracts
Misinformation abounds online, and if you are suffering from cloudy vision, it can be difficult to sort through the noise. It is important to know that secondary cataracts are not caused by the following:
- The IOL becoming cloudy or defective
- Poor post-operative care or not following instructions
- Excessive reading, computer use, or eye strain
- Dietary factors or nutritional deficiencies
- Environmental factors like air pollution or allergens
- The original cataract “growing back”
- Inadequate surgical skill (when performed by qualified surgeons)
How the Yag Procedure is Performed
PCO is very easy to repair with the YAG laser. It is a quick, out-patient treatment that can be completed in five minutes in most cases. To start, your ophthalmologist will dilate your pupils in order to see the posterior capsule clearly. Then, you will sit at a special machine while the doctor performs the procedure. You may see flashing lights, but there should be little to no pain or discomfort.
You may have mild initial side effects following the procedure, such as a gritty sensation in the eye, sensitivity to light, blurred vision, or an increase in floaters but they should all resolve within 48 hours. Severe complications and problems after a YAG laser capsulotomy are rare, but if you have eye pain or sudden vision loss, call your ophthalmologist right away.
Common Yag Posterior Capsulotomy Questions
Patients considering or scheduled for a YAG capsulotomy often have similar concerns and questions. Here are answers to the most frequently asked questions about this procedure.
- How soon after cataract surgery can YAG laser be done?
- YAG laser capsulotomy is typically performed at least 3-6 months after the original cataract surgery so that the eye can heal from the initial surgery, the IOL can settle into place, and for any residual cloudiness to resolve on its own. though it can be done sooner in certain cases. Most ophthalmologists prefer to wait this period because:
- What does YAG stand for?
- YAG stands for yttrium aluminum garnet which refers to the crystal in the laser used to create the specific wavelength.
- Is a glare after YAG laser capsulotomy normal?
- Yes, experiencing some glare after YAG laser capsulotomy is normal and relatively common. However, if it does not resolve after 48 hours, contact an eye doctor.
- Is hazy vision after YAG laser normal?
- Yes, some hazy vision immediately after YAG laser capsulotomy is normal and expected. However, if it does not resolve after 48-72 hours, please contact your eye surgeon.
Your Cataract Surgery Treatment Experts
Advances in ophthalmology mean patients suffering from PCO or secondary cataracts can achieve clear vision once again with a relatively simple procedure. Not everyone that has cataract surgery will develop PCO, but it does occur in 10% of cases. Cataract surgery is a life-changing and very successful surgery, delivering improved vision to over 90% of patients. The team at OCLI Vision is incredibly experienced in cataract surgery, and all surgeons are board-certified and committed to delivering the best outcomes for each patient.
If you need a cataract surgery consultation or would like to know more about the YAG laser, make an appointment at the nearest OCLI Vision office today.