YAG capsulotomy can be very helpful when PCO is making the retinal view poor, but only if the hazy capsule is the main obstruction.
When it is appropriate
Clearing the axis improves both vision and assessment.
- Posterior capsule clearly responsible for a hazy fundus view
- Need to monitor or treat retinal disease, such as diabetes or macular degeneration
- Potential for better vision once the capsule is opened
- Stable lens implant and cornea aside from the capsule haze
- Retinal team in agreement that improved clarity would aid management
When other causes must be excluded
Poor view can come from more than PCO.
- Corneal oedema, vitreous haemorrhage, or dense floaters limiting visibility
- Media opacity such as vitritis or unresolved post‑operative inflammation
- Recent trauma or surgery where YAG would add little benefit
- Need for ultrasound or other imaging if the fundus cannot be seen at all
- Decision to treat underlying pathology first, then reassess PCO
