Since the production of the first laser in 1960, medicine has found many applications for this noninvasive scalpel, coagulator, caliper, welder, and tissue vaporizer. Ophthalmologists were the first surgeons to use lasers routinely. The laser is a source of energy. This energy can be exquisitely tuned, controlled and manipulated to the task at hand.
The Lens After Surgery Before discussing the role of YAG laser in cataract management, a brief review of the lens is in order. A cataract, which is simply a lens that has clouded, is encapsulated within a thin membrane. In all cataract surgeries, the eye surgeon leaves a thin membrane in place to support a lens implant and to protect the retina. Most of these capsules remain clear, but about 20 percent cloud over, causing a recurrence of blurred vision.
The YAG Laser
Today with the advent of the YAG laser, the surgeon can leave the posterior capsule intact, and treat the patients who develop secondary membrane clouding without surgery.
The procedure, called “YAG laser capsulotomy” is as simple as a routine office visit. After dilation of the pupil, the patient sits at the slit lamp. The surgeon focuses the laser beam precisely on a part of the clouded capsule and applies the laser beam. This makes an opening in the cloudy membrane without affecting any other part of the eye. Most common complications are floaters, which may be present for a few days or a few weeks. Occasionally, the eye pressure will increase and medication may be required. Retrospective studies have shown that there is an increase in the rate of retinal detachment in those patients who have had the YAG laser procedure, especially if they are “myopic” (nearsighted) and of a younger age.
Laser surgery is always performed on an outpatient basis. No general anesthesia, no pain, and low cost make it a welcome alternative to traditional surgery. In addition, postoperative complications are extremely rare, and visual improvement is almost immediate. After laser surgery, the patient is immediately able to resume normal activities.