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YAG Laser Treatment

Here at MY Eye Clinic we offer YAG laser for treatment of cloudiness after cataract surgery and for some causes of glaucoma. These procedures are known as YAG Laser Capsulotomy, for the treatment of cloudiness after cataract surgery, and YAG Peripheral Iridotomy, for the treatment of acute angle-closure glaucoma.

YAG Laser Capsulotomy

A relatively common occurrence after cataract surgery is posterior capsular opacification (PCO). This occurs when the back of the clear sac (capsule) of the eye where the artificial lens was implanted goes cloudy. This interferes with light reaching the back of the eye resulting in blurred vision and a feeling as if your cataract is returning. This can happen weeks, months, or years after cataract surgery. It is estimated that this can occur between 10 – 20% of patients at any time after surgery.

YAG Laser Capsulotomy is a simple and generally safe procedure used as a treatment for PCO. Treatment involves creating a gap in the centre of the cloudy capsule using a laser, this allows light to pass through to the retina at the back of the eye, restoring clearer vison.

What happens during my appointment? 

Treatment will be carried out in our clinic in Gosforth by a consultant. Before the procedure your eyesight will be measured and you will be given drops to dilate your pupils and numb the surface of your eyes. Your consultant will then complete some checks before talking you through all the details of the procedure, including benefits and risks of the treatment. Once you are happy and have agreed to treatment the procedure will be performed.

The procedure

This is a quick and completely painless procedure, only taking around 10 minutes.

Your consultant will ask you to take a seat in a chair at the YAG laser machine (similar to the machine you were examined with in the clinic), they may put a contact lens on your eye – this is to help focus the laser beam. You will then be asked to rest your chin in the chin rest on the laser machine, this is to help keep your eye still. A small lens will be used, this allows the consultant to view the membrane clearly so they can apply the laser to the cloudy capsule creating a small hole which generally improves sight.  You might hear repeat clicking sounds and bright light flashes that last fraction of a second.

Following treatment, you will be free to go home. We advise you do not drive yourself home from your appointment as your vision will remain blurred for a few hours after treatment from the dilating eye drops. Once the dilating eye drops have worn off, you will begin to notice an improvement in your vision and sight is usually cleared within a day or two. You may experience itchy, gritty, or sticky eyes and mild discomfort for the remainder of the day after treatment, this is normal. It is also common to notice floaters in your vision immediately after treatment. This is caused by fragments of the capsule floating over the vitreous humour (jelly) of the eye. These floaters will usually settle within a few weeks.

You may be prescribed some drops by your consultant. You will generally use these for a few days following treatment, your consultant will explain how and when to use these before you leave the clinic.

You should expect to be in clinic for around 1 – 2 hours.

What will the final result be? 

The extent of improvement depends upon how cloudy your sight was before treatment and the overall health of your eye. In general, you should expect your vision to be restored to how it was after cataract surgery. Your consultant will discuss with you your expected outcome during your consultation appointment. 

Surgical risks 

Complications of this type of treatment are uncommon. Your consultant will discuss possible complications with you prior to treatment, considering factors such as the overall health of your eye and your general health.

Extremely rare risks include a retinal tear causing a retinal detachment and a build up of fluid, called macular oedema.

Who will I see for treatment? 

For YAG Laser Capsulotomy you will be seen by: Mr Boyce, Mr Doherty, Mr El Assal, Mr Ghosh, Mr Habib, Mr Kotagiri, Mr Morgan.

YAG Laser Peripheral Iridotomy 

In a healthy eye, the aqueous humour (fluid) flows through your pupil into the front of your eye draining away through drainage channels (trabecular meshwork). However, in patients with acute angle closure or narrow angles, the drainage channels can be partially or totally obstructed by the iris (coloured part of the eye) which has moved forward. This prevents the aqueous humour from leaving the eye resulting in increased intraocular pressure (eye pressure). Overtime, the build up of pressure injures your optic nerve – the nerve that carries information from your eye to your brain – resulting in damaged vision.

YAG Laser Peripheral Iridotomy is a simple and generally safe procedure used to treat or prevent acute angle closure. A laser beam is used to create a small hole in the outer part of the iris forming a permanent passage which allows free movement of fluid within the eye. This minimises the risks of high eye pressure which could result in permanent damage to your central and peripheral vison.

What happens during my appointment? 

Treatment will be carried out at our clinic in Gosforth by a consultant. Before the procedure, one of our team will assess your eye and check the pressures. Drops will be put into your eye before the procedure, these will usually be a miotic (drop to make your pupils smaller), a drop to lower your intraocular pressure, and an anaesthetic drop to gently numb the surface of the eye.

The procedure 

This is a quick procedure, taking around 15 minutes. You may feel a slight discomfort, but treatment is generally painless.

Your consultant will ask you to take a seat in a chair at the YAG laser machine, (similar to the machine you were examined with in the clinic). A special contact lens will be will be put on your eye, this allows a clear view of your iris. You will be asked to place your chin on the chin rest of the laser machine, this is to help keep your eye still. Your consultant will direct the laser beam creating a small hole in your iris. Treatment is painless due to the drops used to numb the surface of the eye but you may experience a slight discomfort when the laser is being applied. You may also see a series of bright lights when the treatment is being carried out.

Following the treatment your consultant will place some more drops onto your eye and you will be asked to return to the waiting area. Your consultant will then check your pressures again around an hour after treatment and examine the eye to check the newly formed opening is working well.

We advise you do not drive yourself home from your appointment as your vision may be temporarily disturbed. Any feeling of discomfort is unusual.

You may be prescribed some medication for a few days by your consultant, this is to prevent inflammation and an increase in pressures in the treated eye. You consultant will explain how and when to use these before you leave the clinic.

You should expect to be in the clinic for around 1 – 2 hours.

What will the final results be? 

This procedure is performed to save the sight that you still have, it will not restore any sight you may have already lost, nor will it improve your sight.

Surgical risk

Complications of this type of treatment are uncommon. Your consultant will discuss possible complications with you prior to treatment, considering factors such as the overall health of your eye and your general health.

Occasionally there is a risk of a rise in eye pressure immediately following treatment, you may then need extra treatment (either eye drops or tablets) before you can go home. You might notice some blurriness of vision or glare after the procedure, this tends to settle down quickly after the procedure.

Occasionally the laser beam opening is incomplete, or not big enough. Your consultant will identify this either after your treatment or on your follow-up visit. If this is the case, treatment can be repeated at a later date.

Who will I see for treatment? 

For YAG Laser Peripheral Iridotomy you will be seen by: Mr Doherty, Mr El Assal.

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