Posterior capsule opacification is a complication after cataract surgery. Nd: YAG laser capsulotomy treatment is done to correct this complication which improves vision, contrast sensitivity and reduce the glare. The occurrence of PCO makes the lens opaque. In this procedure a YAG laser is used to create a minute hole in the posterior position of the lens capsule in order to let the light rays pass through for clear vision. It is a safe and effective procedure; nevertheless it also has certain risk factors.
Risks of YAG laser capsulotomy:
- Elevation of IOP (Intraocular Pressure): This is a commonly observed risk after the YAG laser capsulotomy. Certain types of glaucoma if present, could elevate IOP. Acute conditions could cause loss of light perception vision. Preventive medication is administered before and after the procedure to control the IOP(Intraocular pressure).
- Floaters: Floaters are normally experienced and it settles down after some time.
- Cystoid Masular Edema : It is the swelling of the center of the retina occurring after the laser capsulotomy. This built up of fluid cause the blurring of vision.
- Retinal detachment: The nerve layer gets detached at the back of the eye. It may occur a year after the capsulotomy. The occurrence is less common after laser capsulotomy. The experience of flashing lights or vision like dark curtain over the eye mainly affecting the side vision from unspecific direction.
- IOL Damage (IOL Pitting): Lenses made of acrylic material create more damage compared to silicone lenses. The choice of IOL design and type is another factor to this complication. Factors that influence the risk to IOL damage are the inherent resistance of IOL to damage by laser, energy used, IOL position etc.
- IOL Displacement: In some cases the IOL could get displaced into the eyes vitreous as in case of larger /rigid implant or in case of posterior capsule rapture during the initial cataract surgery.
- Endophthalmitis: Uveitis and loss of vision is experienced in some cases.
- Corneal edema: A mild bruising response in the retina is experienced. Corneal edema leads to reduction visual clarityfor a short duration.
- Re-formation of Elschnig’s pearls: This risk is found at the opening of the capsulotomy. This generally resolves without treatment in most cases.
- Other complications: Rarely occurring is corneal endothelial cell loss, Iritis (inflammation of iris). Glaucoma etc.
The follow up checkups and medication routine after surgery are beneficial to keep a check on the eye conditions. It is advisable to report any sign or symptom of excessive pain in the eyes, redness, floaters, vision and get treated and corrected immediately. As observed in any other surgical procedures, Nd:YAG laser capsulotomy treatment also has risks that are easily correctable. These differ according to your eye condition. Serious complications are normally very rare.
In case of any discomfort as mentioned above specifically in terms of vision loss, pain or blurring, it is advisable to immediately report and get it treated as soon as possible.