Patient education: Capsulotomy after cataract surgery (The Basics)

What is a cataract? — A cataract is clouding of the lens in the eye. The lens is the part of the eye that focuses light (figure 1). Cataracts can cause vision problems and vision loss.

Cataracts are treated with surgery. During cataract removal surgery, the doctor takes out the cloudy lens and replaces it with an artificial one. The new lens is held in place by the thin outside layer of the original lens. This layer is called the "capsule" (figure 2).

What is a capsulotomy? — Sometimes, months or years after a person had cataract surgery, the part of the capsule behind the lens can become cloudy and cause blurry vision. This does not mean that the cataract has come back. Capsulotomy is a procedure to fix this.

To do a capsulotomy, an eye doctor uses a laser to make a small opening in the capsule. This lets light pass through, which makes your vision clear again.

This procedure is also called "posterior capsulotomy" or "YAG laser capsulotomy."

How do I prepare for capsulotomy? — The doctor or nurse will tell you if you need to do anything special to prepare. They will also tell you if you need to have someone else drive you home after the procedure.

When you arrive, the staff will confirm your name and which eye needs treatment. Some eye centers might also:

●Take basic measurements like your blood pressure and pulse

●Check your vision in the eye that will be treated

What happens during capsulotomy?

●30 minutes before the procedure, you might be given eye drops to numb your eye and widen, or "dilate," your pupil. You might also get drops to prevent an increase in eye pressure.

●You will sit in a chair and rest your chin and forehead on a device similar to the one used for eye exams. This keeps your head still.

●Typically, the doctor will place and hold a special lens against the front of your eye. This keeps your eye still and prevents you from blinking. Sometimes, they will use a gel inside the lens to help hold it in place.

●The doctor will aim a special laser into your eye, through the pupil. They will use the laser to make a small opening in the capsule. This does not hurt, but you might hear a clicking or popping noise when the laser is used.

●The procedure usually takes about 2 or 3 minutes. It will take a few extra minutes to set up at the laser and then remove the gel from your eye afterward.

What happens after capsulotomy? — Some people get eye drops to prevent inflammation or a rise in eye pressure. In some cases, your eye pressure might be measured before you can go home.

●If you were given eye drops, follow all instructions for taking them. Always wash your hands before using eye drops or touching your eye or face.

●You can return to your normal activities after going home.

●You might have some spots, or "floaters," in your vision. These gradually become less noticeable after a few days.

●Your vision should become clearer within a day or 2 after the procedure.

What are the risks of capsulotomy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Detached retina – The retina is a layer of tissue at the back of the eye. If the retina gets a tear or hole, it can start to peel off, or "detach," from the back of the eye. If this happens, it can cause vision loss and even blindness.

●Increased pressure inside the eye

●The artificial lens moving through the hole in the capsule

●Swelling in the eye

What follow-up care do I need? — Your eye doctor will probably want to see you again within a few weeks after your procedure. Go to this appointment.

When should I call the doctor? — Call your doctor or nurse if:

●You have symptoms of a detached retina – These include a "curtain" or shadow across all or part of your vision, seeing flashes of light, or an increased number or frequency of floaters.

More on this topic

Patient education: Cataracts (The Basics)
Patient education: Detached retina (The Basics)