POSTERIOR CAPSULOTOMY

laser
(Laser after Cataract Surgery)

Posterior capsulotomy is a laser surgical procedure which is sometimes necessary to clear vision after cataract surgery. During initial cataract surgery, the cloudy lens inside the eye is removed and replaced with a clear artificial lens implant. The cataract is surrounded by a clear cellophane-like wrapping. During surgery, the front cellophane wrapping is removed. Then the cataract is removed and the implant placed. The back cellophane wrapping (known as the posterior capsule) remains intact as temporary support until the implant gets cemented in as part of the healing process. In some people, months or even years after cataract surgery, this clear cellophane membrane becomes cloudy. Subsequently, laser treatment is done to restore vision.
Despite attempts at modifying this ‘healing’ response by changing implant design and material, on average 11% of patients will require capsulotomy 1 year after surgery and by 5 years, this rate rises to almost 30%. The cost is not covered by the original surgery but the fee is usually modest at approximately £450.

SYMPTOMS

Decrease in vision is the main symptom which begins anywhere from a few months to many years after cataract surgery. Also, increased difficulty with glare and bright lights as well as decreased ability to read and see far distances. Treatment involves a brief two minute procedure in which a laser is used to create an opening in the clouded membrane. A laser (Light Amplified Stimulated Emission of Radiation) is a focused beam of light of a certain wavelength. The procedure is completely painless and is completed without touching the eye at all. There are no eye drops to use after the procedure and most patients resume all normal activity immediately. Most patients notice an improvement in vision immediately or within the first day or two.

TREATMENT

An invisible laser is focused onto the cloudy membrane behind the lens implant where a small gap is created. This allows light to pass freely to the retina and thereby improves vision. Although the procedure takes just a few minutes to perform, patients should expect to be at the hospital for at least an hour to allow for pre-operative drops to take effect. An excellent animation can be found on the following VIDEO. And detailed information, including risks, can be found HERE.
Complications are rare, but can include inflammation (UVEITIS), raised pressure in the eye and rarely retinal detachment.