YAG Capsulotomy in Philadelphia – James S. Lewis, MD
Also Serving Patients in Bucks County, Phoenixville, Delaware Valley, Warminster, King of Prussia and Conshohocken
Prior to the development of modern techniques the entire cataractous crystalline lens was removed. Today surgeons preserve the posterior capsule and most of the anterior capsule that encases the cataract while removing the inner lens substance. This leaves a naturally supported “bag” to hold the manufactured intraocular lens implant. The new implant is held in place by the same structures that previously held the natural lens. This provides ideal optical characteristics and maintains the physiologic structure of the eye.
No matter how carefully cataract surgery is done some lens epithelial cells remain behind in this bag. In most cases they grow slowly and gradually cover the retained capsular support structures. Patients notice this as a slow worsening of vision. This was once known as an “after-cataract”.
YAG laser capsulotomy is an in-office, 2-minute, painless procedure that almost all cataract patients require at some point postoperatively. While some surgeons tend to brag about their low rates of posterior capsular opacification there is no benefit for the patient. Vision almost always improves dramatically once the YAG procedure is performed. Patients need YAG capsulotomy any time from 6 weeks to 6 years after surgery. There is no value tolerating cloudy vision to preserve the capsule. The lens implant is already well supported and no longer requires the central posterior bag.
YAG capsulotomy is only required once per eye. If you vision has degraded since cataract surgery you should return to your surgeon promptly to recover your visual clarity. There is no homework after YAG capsulotomy, i.e., no drops, no restrictions, and almost no recovery time. Our Philadelphia cataract surgery patients routinely drive home following the YAG procedure.
Video of a standard YAG Capsulotomy of the posterior capsule seen at 1/4 speed.