Why Do Some People Need Laser Treatment After Cataract Surgery?
Cataract surgery has become one of the most commonly performed surgeries worldwide. This is due to a combination of the commonness of cataracts and the procedure’s safety and effectiveness. But in some cases, further treatment may be required after cataract surgery. In this article, we’ll aim to answer the question: Why do some people need laser treatment after cataract surgery?
Cataracts is the most common cause of blindness globally. They occur when the natural proteins in the eye’s lens begin to break down and clump together. Eventually, this clump begins to turn the lens cloudy – often with a yellow or brownish tint. This results in impairment in vision by affecting the eye’s ability to focus and detect colour and detail.
While the development of cataracts is considered a natural part of ageing (around 42% of people aged over 75 are thought to be affected in the UK), if left untreated, their impact can be life-changing. Thankfully, cataract surgery is now a routine procedure with extremely high safety and success rates.
How does cataract surgery work?
As we get older, the once clear natural lenses in our eyes begin to become cloudy where they were once as clear as glass. In order to rectify this and once again facilitate effective vision, this cloudy tissue needs to be removed. Cataract surgery was designed to do exactly that.
What began as a daunting procedure with low success rates and a high risk of complications has today become a simple operation conducted an estimated 400,000 times a day by the NHS alone.
During a cataract surgery procedure, your surgeon will create small incisions in the surface of the eye using either a blade or a laser. These incisions allow access to the cataract, allowing the surgeon to break it down and, ultimately, remove it. A probe is inserted into the eye which delivers ultrasonic waves to break down the cataract. The pieces are then suctioned out of the eye.
As cataract surgery involved removing the eye’s natural lens, a new one must replace it. Therefore, following the removal of the cataract, an artificial lens – known as an intraocular lens (IOL) – is implanted. IOLs can come in a range of sizes and refractive prescriptions. In some cases, IOLs can be specifically selected to improve common refractive errors such as hyperopia (long-sightedness), myopia (short-sightedness), and astigmatism.
Recovering from Cataract Surgery
Most patients are able to return home on the same day as their cataract surgery. While your vision should begin to return to normal after a few days, it can take between four and six weeks to fully recover. During this time, you may experience a number of side effects, including:
- Blurred vision
- Double vision
- Red or bloodshot eye
These side effects are completely normal; however, if you are concerned, your surgeon will be available to check that your recovery is going smoothly.
While surgery will remove the cataract and replace the lens with an IOL, you may still need to wear glasses or contact lenses to achieve optimal visual acuity.
When might further treatment be required?
The majority of cataract surgeries are completed successfully, without any serious complications; however, in some cases, complications may arise for which further treatment is required.
Posterior capsule opacification
Posterior capsule opacification (PCO) is a post-cataract surgery complication that can cause vision to become cloudy again. It can be so significant that it can even appear that the cataract has returned – but that is not the case.
PCO occurs when cells remaining after the surgery grow over the back (posterior) of the lens capsule. This causes the capsule to thicken and become cloudy (opacification). As a result, light is not able to enter the eye effectively, causing vision disruption. This may also lead to other side effects such as nighttime glare.
Capsule thickening can happen as early as three months after your surgery but it most commonly occurs after two or more years. Although PCO affects your vision, it is not associated with any other harm to your eye. YAG capsulotomy is the only way to treat PCO.
Laser Treatment – YAG capsulotomy
When PCO occurs, the patient will require a laser treatment called YAG capsulotomy in order to see clearly again. The procedure involves using a high-precision laser to create a small hole in the cloudy lens capsule. This allows light to once again reach the retina at the back of the eye, restoring vision.
YAG capsulotomy is a very low-risk procedure with most patients able to return home directly after their treatment.