YAG capsulotomy may still be suitable if lens position is only slightly off‑centre, but significant decentration or instability should be addressed first.
When YAG can proceed
Mild decentration often causes little optical impact.
- Lens well supported with only small, stable displacement
- Symptoms mainly attributable to PCO rather than lens misalignment
- No evidence of progressive tilting, subluxation, or zonular weakness
- Careful, central capsulotomy planned to avoid stressing the haptics
- Understanding that minor positional quirks are unlikely to change with YAG
When to postpone YAG
Lens stability must be secure.
- Noticeable visual aberrations from tilt or decentration
- Suspicion of loose zonules or capsular bag instability
- Possible need for recentring, suturing, or lens exchange
- Recognition that opening the capsule makes future surgery more complex
- Decision with a specialist to correct position before or instead of YAG
