YAG capsulotomy is a laser procedure used to treat posterior capsule opacification (PCO), the most common complication following cataract surgery. ¹ The procedure uses a focused neodymium:YAG laser to create a small, precise opening in the clouded posterior capsule that sits behind the implanted intraocular lens, thereby restoring a clear optical pathway to the retina.
During cataract surgery, the natural lens is removed and replaced with an artificial intraocular lens (IOL), which is typically positioned within the remaining lens capsule, a thin, transparent membrane. Over months to years following surgery, residual lens epithelial cells left on the anterior capsule can proliferate, migrate, and undergo epithelial-mesenchymal transition, resulting in opacification of the posterior capsule. ¹ This process causes visual symptoms similar to the original cataract: blurred vision, glare, reduced contrast sensitivity, and difficulty with reading or driving.
YAG capsulotomy addresses this by using the laser’s photodisruptive energy to create an opening, typically 3 to 4 millimetres in diameter, in the central posterior capsule. The procedure is performed in an outpatient setting without incisions or anaesthesia beyond topical drops. Treatment typically takes a few minutes, and visual improvement is often immediate. ³
The procedure is highly effective, with success rates exceeding 95% for visual restoration. ³ Complications are rare but include transient intraocular pressure elevation, vitreous floaters from capsular debris, and in uncommon cases, retinal detachment or cystoid macular oedema. ² A structured clinical pathway with proper pre-operative assessment, appropriate energy settings, and post-operative monitoring minimises these risks.
References
- Awasthi N, Guo S, Wagner BJ. Posterior capsular opacification: a problem reduced but not yet eradicated. Archives of Ophthalmology. 2009;127(4):555-562.
- Javitt JC, Tielsch JM, Canner JK, Kolb MM, Sommer A, Steinberg EP. National outcomes of cataract extraction: increased risk of retinal complications associated with Nd:YAG laser capsulotomy. The Nd:YAG Laser Posterior Capsulotomy Study Group. Ophthalmology. 1992;99(10):1487-1497.
- Findl O, Buehl W, Bauer P, Sycha T. Interventions for preventing posterior capsule opacification. Cochrane Database of Systematic Reviews. 2010;(2):CD003738.
Related Topics
- Private YAG Capsulotomy Checklist
- What Is a YAG Laser?
- What Is YAG Capsulotomy?
- What Is Posterior Capsule Opacification (PCO)?
- Why Does Posterior Capsule Opacification Occur After Cataract Surgery?
- How Common Is Posterior Capsule Opacification?
- How Do You Know If You Need YAG Capsulotomy?
- Can Blurred Vision After Cataract Surgery Be Caused by Something Other Than PCO?
- Do You Need an OCT Scan Before YAG Capsulotomy?
- Is OCT Worth Paying for Before YAG Capsulotomy?
- Who Should Perform YAG Capsulotomy?
- Is YAG Capsulotomy Painful?
- How Long Does YAG Capsulotomy Take?
- How Should I Prepare for YAG Capsulotomy?
- What Happens During YAG Capsulotomy?
- Can YAG Capsulotomy Damage the Intraocular Lens?
- Is YAG Capsulotomy Safe?
- What Are the Risks of YAG Capsulotomy?
- Can YAG Capsulotomy Cause Retinal Detachment?
- What Is Lens Pitting After YAG Capsulotomy?
- What Are Floaters After YAG Capsulotomy?
- How Long Do Floaters Last After YAG Capsulotomy?
- Do You Need Steroid Drops After YAG Capsulotomy?
- What Follow-Up Is Needed After YAG Capsulotomy?
- What Happens If YAG Capsulotomy Is Incomplete?
- Will I Need YAG Capsulotomy More Than Once?
- How Much Does YAG Capsulotomy Cost in the UK?
- Can I Have YAG Capsulotomy If I Have Glaucoma?
- How Soon After Cataract Surgery Can I Have YAG Capsulotomy?
