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Nd-YAG (Neodymium Yttrium-Aluminum-Garnet) Laser Capsulotomy

​What is a Nd:YAG Laser Capsulotomy?

A Nd:YAG (neodymium:yttrium-aluminum-garnet) laser capsulotomy is a procedure used to improve your vision after cataract surgery. It is a simple, safe and commonly performed procedure.
During your cataract operation, the natural lens (that had become cloudy) inside your eye was removed. A new artificial lens was put inside the lens bag (capsule) in your eye. In a small number of patients, this capsule, which is originally transparent thickens after surgery and becomes cloudy. This interferes with the light reaching the back of the eye. When this happens, your sight becomes cloudy, and you may get glare in bright light or from lights at night. Capsule thickening can occasionally happen in the months after your cataract operation, but more commonly occurs about two years after surgery.
Nd:YAG laser capsulotomy involves directing a laser beam to the thickened capsule. This creates a small opening in the center of the capsule, allowing light to pass through once again.

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Image of the different appearances of the thickened posterior capsule post cataract surgery. 

What happens during a Nd:YAG Laser Capsulotomy?

You will need to visit the outpatient department for about half a day. The treatment will be performed in a laser treatment room. Special preparations such as fasting or changing into operating theatre clothes are not necessary. You will have some drops put into your eye to dilate your pupil, and an anaesthetic eye drop to numb the eye.
You will then sit in front of a laser machine and the doctor will place a special lens on your eye before applying the laser beam. This lens allows the doctor to view the membrane clearly so he/she can apply the laser. The treatment is painless and takes approximately 15 minutes.
After the procedure, you will return to the waiting area. Your doctor or nurse may check your eye pressure about half an hour later. You may be given eye drops to reduce inflammation in your eye.

What are the benefits of having a Nd:YAG Laser Capsulotomy?

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Post-YAG laser capsulotomy

The laser treatment is applied to remove the cloudy, thickened capsule in your eye and aims to restore your vision to how it was after your cataract operation.

Are there any Risks Associated with a Nd:YAG Laser Capsulotomy?

Complications after this treatment are very uncommon. Rarely, the pressure inside the eye rises after the laser treatment. If this occurs, you may need extra treatment before you can go home. This treatment usually comes in the form of eye drops, but may also come in the form of tablets.
Uncommonly, the opening made by the laser beam may be incomplete, or not large enough. This will usually be discovered on your follow-up visit. You will therefore need to repeat the laser treatment.
Rarely, some patients can get a build up of fluid in the macula, called cystoid macular oedema (swelling), which causes blurring or distortion of vision. Treatment in the form of eye drops will be required to resolve this.
Another rare complication is retinal tear or detachment. If you experience sudden onset of floaters, flashing lights or blurring of vision, you should seek advice at the eye clinic immediately.

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Image showing a patient undergoing the laser procedure.

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