About Dr Brian Ang

Laser Capsulotomy

Why is laser capsulotomy necessary?

Laser capsulotomy is performed for patients who have developed posterior capsular opacification (PCO) after cataract surgery.

During cataract surgery, the cloudy lens inside your eye is removed and replaced with an artificial clear lens implant. This lens implant sits inside a natural bag (capsule) inside the eye. The capsule holds the lens implant in the correct position in the eye.

Sometimes the capsule develops some scarring, wrinkling and thickening. This is called posterior capsular opacification (PCO). PCO can cause your vision to become blurry and foggy You may also notice increased glare.

(Images adapted from the internet)

What does laser capsulotomy?

The laser makes an opening in the centre of the capsule, thereby clearing away the posterior capsular opacification. This opening allows more light to enter your eye so you can see more clearly.

(Images adapted from the internet)

Sometimes, the opening may close up over time. If this occurs, the laser will need to be repeated.

Please note that laser capsulotomy is not laser vision correction. After laser capsulotomy, you will most likely still need to wear glasses to help you see clearly.

What are the potential risks?

Laser capsulotomy is a very safe procedure. Complications are very uncommon. These include:

● Scratch on the front window of the eye (cornea).
● Inflammation in the eye.
● Lens implant dislocation through the opening in the capsule.
● Detachment of the retina. This can be treated with retinal detachment
   surgery (vitrectomy).
● Fluid at the central part of the retina (macular edema). This is usually mild
   and settles with a course of anti-inflammatory eye drops. Occasionally, it
   can be severe and cause reduced vision in the long term.

What should I expect?

Laser capsulotomy is an office-based procedure, and does not require sedation or hospital admission.

Before laser:

On the day of your procedure, please take all your usual medications unless otherwise advised. You will not be able to drive home on the day of the procedure, so you will need to arrange for someone to take you home. Please allow at least 2 hours.

Before the laser procedure, 2 types of eye drops will be put in the eye undergoing laser:

● Drops to enlarge the pupil. These can take up to 30 minutes to work.
● Local anesthetic to numb the eye.

During laser:

Laser capsulotomy is performed with the patient seated at the laser machine. The laser is delivered through a special contact lens that is placed on the eye. You will not feel any pain or discomfort during the procedure, but you may notice some flashing lights. The laser takes only a few minutes to do.

(Images adapted from the internet)

After laser:

It may take a few days before you notice an improvement in your vision.

Usually no eye drops are required after laser. However if there is inflammation after laser, you may be given a steroid anti-inflammatory eye drop (usually Fluorometholone) to use 3 times daily for 1 week.

Over the next few days, you may experience some (floaters). The floaters will gradually settle without any treatment.

You will usually be reviewed 4 to 6 weeks after laser.


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