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Cataract Surgery and YAG Laser Capsulotomy


My mother is 80 years old.

She had cataract surgery on her right eye in December 2019. In addition to the cataract, she also had glaucoma and pseudoexfoliation syndrome (PXF) in that right eye.

She had follow-up visits 24 hours after the surgery and 4 weeks after the surgery. Both visits were conducted by an optometrist who worked in partnership with the ophthalmologist who had done the surgery. The ophthalmologist himself was not in the office during these follow-up visits.

At the second follow-up visit, my mother complained that her vision in the right eye was blurry.

Her third follow-up visit was supposed to happen in March 2020, and that visit was going to be conducted by the ophthalmologist himself. However, because of COVID-19, the medical practice decided to push (all visits considered by the medical practice to be non-emergency visits) forward by a few months. So, my mother finally saw the ophthalmologist in June 2020, 6 months after the original surgery.

The ophthalmologist examined my mother, said that there was a film behind the new lens, and said that my mother would need a YAG laser capsulotomy.

A second ophthalmologist examined my mother, and confirmed that she would need the YAG laser capsulotomy.

I'm trying to understand exactly what this laser procedure will do. I understand that he posterior capsule that holds her new lens is very cloudy. One brochure for the YAG laser capsulotomy states, that only a small portion of the cloudy posterior capsule will be removed by the laser. However, some online information seems to imply that the entire cloudy posterior capsule will be removed.

So, how much of the cloudy posterior capsule will be removed?

Thanks for any info.

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Avatar universal
Hi! What I believe is YAG laser treatment has been effective with lots of people. It has bettered the vision quality and it is normal for people who have had this procedure to see floaters in their field of vision for up to a few weeks. But still, if she’s experiencing the blurriness in the vision it could be the hands of PXF. Now that is something difficult to treat. But don’t worry there are laser treatment options for that as well and it is safe to undergo it. Anyway before taking such steps, ensure the quality of cataract surgery she went through, for example, if this was undertaken under the verion cataract surgery system?. This could get you some relevant information about the eye’s status through a detailed eye-mapping. Laser treatments are truly effective for such disorders and have worked out for many. But the result can vary concerning the condition of an individual eye. Hence I strongly suggest you get suggestions from senior specialists.
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177275 tn?1511755244
Only a small opening will be made. The procedure is done in a laser room not an surgical room. It typically takes about 1-2 minutes and is painless.  Just FYI.  If the ophthalmologist has not done a macular OCT one should be done PRIOR to the yag laser to be sure your mother does not have swelling of the macula (cystoid macular edema) or age related macular degeneration. Approximately 15-20% of people having cataract surgery will eventually need the yag laser. Prior to the year 2000 it was like 85-90%.  Instruments called 'polishers' were then used to try and wipe capsule clear.  Also patients with PXF (usually PXE) need extra care and smaller openings because the IOLs are prone to dislocate.
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Hello, Dr. Hagan. Thank you for your response.

I will definitely find out whether the many tests that have been run on my mother by the surgeon and by the second ophthalmologist include the macular OCT.

Also, if only a small portion of the cloudy posterior capsule is removed (and most of the cloudy posterior capsule is left intact), then won't the intact portion of the cloudy posterior capsule continue to cause problems for my mother? How does removing only a small portion of the capsule help my mother?

Furthermore, I have read that the YAG laser capsulotomy is the only solution for a cloudy posterior capsule. Is that correct?

Because we see through only a tiny central part of the capsule.  Yes when vision is bad enough to consider surgery and the cloudy posterior capsule is the cause then Yag capsulotomy is only realistic procedure.
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177275 tn?1511755244
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