“It feels like my cataract has come back”
A cataract cannot grow back. But months or even years after a successful operation, some people notice their vision becoming hazy or glary again.
During cataract surgery, the back part of the lens capsule is left in place to hold the new lens implant. That thin membrane is normally clear, but over time it can thicken and cloud. When the clouding reaches the centre, vision blurs, much as it did with the cataract. Doctors call this posterior capsule opacification.
The treatment
The clouded membrane is cleared with a laser called a Nd:YAG laser. It makes a small opening in the centre of the capsule, so light can pass straight through again. No cut is made in the eye. The laser passes through the cornea and the lens implant and acts only on the membrane behind them.
What happens
- Drops widen your pupil, so the doctor can see the capsule clearly.
- You sit at the laser machine with your chin on a rest. A strap may steady your head.
- After numbing drops, the doctor holds a small contact lens against your eye to focus the laser.
- A red aiming light is visible. Each laser pulse makes a soft click or popping sound.
- The doctor makes a series of pulses until the opening is large enough. Then the lens is removed and drops are put in.
The treatment takes a few minutes and is not painful.
Afterwards
Glare is common for a few hours, because the pupil is still wide. Vision improves soon afterwards, back to what it was after your cataract operation, unless something else, such as a retinal condition, is affecting it. You may notice a few new floaters for a few days.
You may be given eye drops. Most people go back to normal activities the same day.
Risks
The treatment is low-risk, but not risk-free. The eye pressure can rise for a short time afterwards. This is usually mild, but it matters more if you have advanced glaucoma, so your doctor may check it. Retinal detachment has been reported after the treatment, rarely. Report any new flashes, a shower of floaters or a shadow in your vision straight away.
Cost and coverage
YAG capsulotomy is classed as a surgical procedure and may be covered by PhilHealth. Ask reception to check your plan.
This guide explains; it does not diagnose. Your doctor’s advice about your own eyes comes first.