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What is a YAG Capsulotomy?

By Toni Henthorn
Updated Mar 03, 2024
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A yttrium aluminum garnet (YAG) capsulotomy is an outpatient laser surgery performed by an ophthalmologist on a patient who has previously had cataract surgery — the removal a cloudy lens from the eye. The surgeon first opens the elastic bag, or capsule, surrounding the lens in the anterior portion of the bag. He or she removes the foggy lens from the bag, which is left in the eye to secure the artificial lens implant in place. If the bag clouds up at any time after cataract surgery, the YAG capsulotomy perforates the center of the bag behind the implant, creating a hole and producing a clear window for unobstructed vision.

About 20 to 25 percent of cataract surgery patients develop fibrosis or haziness of the capsule. It may appear within months of the surgery, or it may take several years to develop. The incidence and frequency of the posterior capsule clouding depends on several factors, including the degree to which the bag was cleaned in the original surgery, the age of the patient, and the implant material.

Not all of the cases require YAG capsulotomy. Eye surgeons reserve laser treatment for those who experience visually significant symptoms related to the cloudiness. Commonly described symptoms of advanced capsule clouding include blurred vision, double vision, decreased ability to distinguish between shades of gray, and glare — especially with night driving. Glare testing can be performed in the ophthalmologist's office to ascertain the degree to which the capsule haze is impacting a patient's vision.

A YAG posterior capsulotomy is accomplished in an office setting at a machine that resembles the slit lamp used by the ophthalmologist to examine the eye. The procedure is painless and does not require anesthesia. After the pupil is dilated, the treatment can usually be completed in less than five minutes. The vision may improve instantaneously, or it may gradually clear over a few days. There are usually no activity restrictions during the recovery period.

The potential benefit of enhanced vision must be weighed against the risks of YAG capsulotomy. Risks include increased eye pressure, damage to the implant, bleeding in the eye, and retinal detachment, which is a separation of the thin inner layer of the back of the eye from its underlying nourishment layer. Overall, complications occur in very few cases, and the risk of retinal detachment is about two percent. In the vast majority of cases, the benefits of YAG capsulotomy far outweigh the risks.

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Discussion Comments
By anon243096 — On Jan 26, 2012

I had cataract surgery several days ago, got the patch off the next day and I am experiencing dizziness in the left eye. The doctor had told me I had some bleeding, and will have the haziness. I see him tomorrow. If I still have the haziness, what is next for the ophthalmologist to do?

By anon226897 — On Nov 02, 2011

My biggest fear right now is that it seems this procedure is to be done following cataract removal. My specialist plans to do it to prevent the growth of cataracts. Any comments?

By snickerish — On Oct 25, 2011

I am glad someone wrote an article about this YAG capsulotomy because cataracts and a lot of other eye problems run in my family. I should not have to worry about this for several years, but it is good to know about in case I do develop cataracts early or at all.

I do worry a little bit that this article states that it can take years for bad side effects to show. But it seems like a twenty-five percent chance of something bad is lower than something bad happening people with cataracts leave it untreated.

It seems like there are potential side effects for every surgery and medicine you take regardless of how thorough you and your doctors are.

I am sure most eye doctors will know what is best for each different person. Also they will know be notified of your existing conditions, to know whether a surgery and/or medicine is worth the potential risks involved.

By runner101 — On Oct 24, 2011

My Mom recently had YAG capsulotomy surgery, which many of us lay people refer to as the laser surgery that people with bothersome cataracts get.

She says the laser surgery for her cataracts was basically easy and not too bad. It was a little uncomfortable, but not as uncomfortable as she thought it would be. She said she only had pain for a couple hours after the surgery, which was reduced with medicated eye drops and pain medicine. She had to put certain eye drops in for a few weeks, but other than that, no hassle.

It has only been a month since my Mom's laser surgery, and she says so far it has been nothing but good outcomes. She says she can see better, and that the pressure in her eye is lower. I, of course, am so happy, as we were worried she was going to go blind and/or not being able to be as independent as she is.

Thank goodness for this surgery, and I hope it continues to help my Mom and others as well.

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