Secondary Cataract Treatment with YAG Laser Capsulotomy

Has your vision become cloudy again months or years after cataract surgery? Your cataract has not grown back. Instead, you may have developed a common condition called a secondary cataract, or posterior capsular opacification.

What Is a Secondary Cataract?

A secondary cataract is cloudiness that develops behind the artificial lens placed during cataract surgery. The medical term for this condition is posterior capsular opacification, often shortened to PCO.

During cataract surgery, your eye surgeon removes the natural lens that has become cloudy and replaces it with a clear artificial lens called an intraocular lens, or IOL. A thin, transparent membrane called the posterior capsule is left in place to support the new lens.

Over time, cells can collect and grow across the back of this capsule. When the capsule becomes cloudy or opacified, light can no longer pass cleanly through the eye. This may cause blurred, hazy, or distorted vision.

Although PCO is commonly called a secondary cataract, it is not a new cataract growing inside the eye.

Older woman wearing reading glasses and reading a book at home, illustrating vision changes from a secondary cataract.

Symptoms of PCO After Cataract Surgery

Posterior capsular opacification often develops gradually. You may notice that your vision is no longer as sharp or consistent as it was after cataract surgery.

Blurred outdoor view illustrating cloudy vision caused by a secondary cataract.

Common secondary cataract symptoms include:

  • Blurred or cloudy vision
  • A hazy or foggy appearance
  • Increased glare from headlights or bright sunlight
  • Halos around lights
  • Difficulty driving at night
  • Reduced contrast or faded colors
  • Difficulty reading or seeing fine details
  • A gradual decline in vision months or years after cataract surgery

Your eye doctor will perform an eye exam to determine whether posterior capsular opacification is responsible for your vision changes. A complete examination helps your doctor identify the cause before recommending YAG laser treatment.

Secondary Cataract Treatment: YAG Laser

YAG laser capsulotomy is the standard treatment for posterior capsular opacification. It is sometimes called a YAG procedure, posterior capsulotomy, YAG eye surgery, or laser surgery after cataract surgery. YAG refers to yttrium aluminum garnet, a crystal used to produce the laser energy. The complete name of the technology is the Nd laser.

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YAG Capsulotomy Procedure

A YAG laser capsulotomy is usually performed in an outpatient eye clinic rather than an operating room.

Your doctor may place drops in your eye to dilate your pupil. Numbing drops may also be used to keep your eye comfortable.

Your eye pressure may be measured before or after treatment. Depending on your medical history, your doctor may prescribe an eye drop to help control inflammation or eye pressure.

You will sit in front of a laser instrument similar to the microscope used during a routine eye examination.

Your ophthalmologist creates a small opening in the cloudy posterior capsule. This opening allows light to pass through the lens implant and reach the retina without being blocked by the opacified tissue. The artificial lens remains in place. The laser does not remove or replace your IOL.

Your vision may initially be blurry because of the dilating drops. You may also notice a few temporary floaters as small particles from the treated capsule move through the eye.

Your doctor will explain whether you need eye drops, activity restrictions, or a follow-up examination. Because dilation can temporarily affect your vision and light sensitivity, ask whether someone should drive you home.

YAG Laser Eye Surgery Recovery Time

Barnet Dulaney Perkins Eye Center patients enjoying clearer vision after treatment for posterior capsule opacification.

Recovery after YAG laser capsulotomy is typically much faster than recovery from cataract surgery. There is no surgical incision, and no replacement lens is implanted.

Many patients notice improvement soon after treatment, although vision may remain temporarily blurry from dilation or inflammation. Improvement may continue over the next several days.

Your doctor may recommend that you:

  • Use prescribed eye drops as directed
  • Avoid rubbing your eye
  • Attend any scheduled follow-up appointments
  • Contact your care team if your vision worsens instead of improving

YAG Laser Capsulotomy Cost and Insurance Coverage

Many medical insurance plans cover YAG laser capsulotomy when posterior capsular opacification is affecting vision or daily activities. Coverage and out-of-pocket costs vary by plan. The cost of YAG laser capsulotomy depends on several factors, including:

 

Your insurance plan

Whether the procedure is medically necessary

Your deductible and coinsurance

Whether additional testing is required

The clinic or facility where treatment is performed

Eye doctor in black scrubs speaking with an older patient about secondary cataract treatment in an ophthalmology exam room.

Restore Vision Clouded by a Secondary Cataract

The ophthalmologists at Barnet Dulaney Perkins Eye Center diagnose and treat secondary cataracts at convenient locations throughout Arizona. Schedule an evaluation with Barnet Dulaney Perkins Eye Center to find out whether a secondary cataract/posterior capsular opacification is affecting your vision.

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FAQ: Secondary Cataracts and YAG Procedure

A secondary cataract is cloudiness that forms in the capsule behind an artificial lens after cataract surgery. Its medical name is posterior capsular opacification, or PCO. It is not a second cataract growing inside the eye.

PCO means posterior capsular opacification. “Posterior” refers to the back portion of the capsule, while “opacification” means that normally transparent tissue has become cloudy.

A YAG laser is a type of medical laser used in ophthalmology. YAG stands for yttrium aluminum garnet. For secondary cataracts, the laser creates an opening in a cloudy posterior capsule so light can pass through the eye more effectively.

No. Cataract surgery removes the eye’s cloudy natural lens and replaces it with an artificial lens. A YAG capsulotomy uses laser energy to open a cloudy capsule behind an existing lens implant. The artificial lens normally remains in place.

Posterior capsular opacification may develop within months of cataract surgery or many years later. Cloudy vision immediately after cataract surgery can also be related to normal healing, corneal swelling, inflammation, dry eye or another condition. Contact your surgeon if your vision is not improving as expected.

A YAG capsulotomy usually only needs to be performed once in each eye because the laser creates a permanent opening in the posterior capsule. Repeat treatment may be possible in unusual situations, but your ophthalmologist must determine why the visual opening has become obstructed.

Treatment depends on the cause. When posterior capsular opacification is responsible, YAG laser capsulotomy is generally used to create an opening in the cloudy capsule. Other causes of blurred vision require different treatments.