Laser Eye Surgery for Secondary Cataracts, After Cataract Surgery By William Goldstein on March 04, 2013


Some people who undergo phacoemulsification or extracapsular procedure for cataracts experience clouding of the lens that covers the capsule, which is called posterior capsular opacification or secondary cataract. Sometimes, this cloudiness affects vision, which can be corrected through a laser surgery called Nd: YAG (neodymium-doped yttrium aluminum garnet) posterior capsulotomy. The Nd: YAG laser  is a laser eye surgery employed to create a hole in the black, clouded lining of the capsule so as to allow light through the membrane to the retina that is located at the back of the eye.


The criteria to have the surgery


The cloudiness that some people experience after cataract surgery can happen after several months or even after years. In certain instances, it can become very thick causing a vision loss that can be as bad as cataracts themselves. The decision to undergo the procedure can be due to glare caused by bright light, poor vision affecting lifestyle or work, failure to pass vision test for driver’s license, double vision, significant difference in vision between two eyes, or another eye disease that threatens vision. The procedure is considered unnecessary unless the deterioration in vision is significant.


After the surgery


Nd: YAG laser posterior capsulotomy is considered an outpatient surgery and does not necessitate anesthesia as it is  painless. Patients must wait in the hospital for about 1-2 hours after the surgery so that the pressure inside the eye can be checked. This pressure is what maintains the shape of the eye.


Some people who undergo the surgery experience a new floater. The surgery is not a guarantee that posterior capsular opacification will never recur. However, certain types of lenses are known to lower the risk of opacification. These lenses must be discussed with your cataract surgeon in Troy before undergoing the cataract surgery in the first place.


The risks of surgery


The problem, which is most commonly seen after Nd: YAG laser posterior capsulotomy is increased pressure inside the eye in the short term. Other risks involved are swelling of central part of the retina, bleeding into front part of the eye, swelling of clear covering of the eye, and retinal detachment.


Retinal detachment can be a serious complication leading severe vision loss. This complication is seen in about 1 out of 50 patients who undergo Nd: YAG laser.


As with any surgery, the risks of undergoing Nd: YAG laser should be weighed against the benefits that patients stand to derive from it, before making the decision. It is advisable to have a thorough discussion about the decision with the surgeon before opting for the surgery.

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Dr. William S. Goldstein

Laser Eye Care Center

William S. Goldstein, MD, has been practicing laser eye surgery since 1991. He was one of the first doctors to offer advanced eye care in all of Michigan and is a member of several prestigious organizations: 

  • American Board of Ophthalmology
  • American Academy of Ophthalmology
  • American Society of Cataract and Refractive Surgeons

If you are ready to enhance your vision, call our office at (586) 323-2020 or request a consultation online.

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