Thickening of the posterior capsule & laser treatment: |
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The film behind your lens implant can thicken....
like frosted glass (arrow). It can only occur after cataract surgery. |
What a cataract is |
| Normally light enters the eye from the front, passes through
a clear lens, and reaches the back of the eye so you can see. When
the lens became cloudy like frosted glass, light could not pass
through, and you could not see properly.
When a human lens becomes cloudy, it is called a ‘cataract’. See animation. |
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A side view of an eye showing a cataract scattering light. |
Cataract surgery |
| When you have a cataract operation, a clear plastic lens is placed in the ‘bag’ left behind when the cataract is removed. The new lens focuses the light onto the back of the eye, just like the original human lens. See animation. |
Light passes through the clear lens implant. |
The capsule |
| The ‘bag’ is called a capsule:
the capsule supports the implant.
This capsule is normally clear like a glass window. It is very thin, like cellophane.
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 the capsule behind the lens implant (arrow) |
Capsule thickening |
In a small number of patients the capsule thickens,
and becomes a little opaque, like a frosted glass window. This stops
the light reaching the back of the eye. |
The thickened capsule scatters light |
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Laser treatment |
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Laser treatment makes a small hole in the centre of the capsule, and can restore your vision to how it was after the cataract operation. The treatment does not hurt, and you hardly notice anything at all. It takes about fifteen minutes; the laser machine is in the outpatient clinic. To carry out the laser, the front of your eye is anaesthetised with an anaesthetic drop, and a small contact lens is placed on your eye. Placing your head on the frame of the laser machine to keep your eye still, the doctor focuses the laser on the capsule. The laser then makes small holes in the capsule, often in a circle. The holes join up and, like tearing a postage stamp, a small hole is made in the capsule. The capsule segment drops to the bottom of the eye (over minutes or hours). Larger capsulotomies are helpful. |
 Laser makes a small hole in the capsule. Light can then pass directly onto the retina, without being scattered. |
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Usually the laser is applied in a ring |
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After laser |
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For a few days after the laser you may notice a lot of floaters. The capsule segment drops to the bottom of the eye over a few days, and is normally not very noticeable. You may notice large or small floaters at this time. See the floaters. |
Is the laser safe? |
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The laser is considered very safe, with very few complications. Occasionally a little more laser is need to release the capsule on a second occasion. Only a small hole is needed, so the lens implant still has enough support. |
Can there be complications? |
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Less often, the laser can disturb the retina. Very rarely a little fluid can build up in the retina. Also very occasionally the laser can disturb the retina, damaging it a little months or a year or two later. If this happens and makes a tiny tear in the retina, you may notice
If you notice a lot of flashes and floaters all of a sudden, you need to have your eye examined to check if there is a small tear in the retina. If a ‘curtain’ or ‘shutter’ drifts across your vision, you need to see an ophthalmologist the same day to check for a retinal detachment (this usually means attending an 'Emergency’ Eye Department, such as that at Birmingham and Midland Eye Centre, City Hospital). In addiion there are other very unusual complications. |
the retina of the eye: this is like the ‘film’ of a camera |
Precautions |
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As a precaution you should test your sight every day by covering one eye and checking your sight in the other eye (the eye that has had the laser). It is normal to have floaters for 3 weeks after laser. The retina of the eye may be VERY OCCASIONALLY affected by the laser causing a more serious problem (see above ). You should have your eyes checked each year by your optometrist after this treatment, for glaucoma and other problems. If you have a slightly unusual eye, these check ups are critical. For example, if an injury caused your cataract, have your eyes checked one month after treatment and every year. Similarly, if you have glaucoma a pressure test soon after the operation is helpful. |
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Leaflet download |
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If you are a health professional and want to have a leafet to give to give to patients, instead of this web page, see 150k Adobe PDF. Alternatively, this is a Microsoft Publisher document click here, and you are welcome to download it and print copies. You are welcome to make changes for your patients (you can edit the leaflet in Microsoft Publisher). You will need M Publisher 2000 to open and print the document. M
Publisher is bundled as part of Microsoft Office. The only condition
is that you let me know if there are any errors. |
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Photos |
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thickened capsule after cataract surgery, before laser. This capsule is particularly thick...laser is normally carried out earlier larger |
Yag Laser capsultomy after laser, a clear visual axis larger |
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