Undergoing YAG Laser Capsulotomy

Undergoing YAG Laser Capsulotomy

Patient Information

Ophthalmology Department

• Author ID:     MC
• Leaflet Ref:  Ophth 018
• Version:       4
• Leaflet title:  Undergoing YAG Laser Capsulotomy
• Last review:  August 2025
• Expiry date:  August 2027

What is a YAG laser capsulotomy? 

A YAG capsulotomy is a special laser treatment used to improve the vision after cataract surgery.  It is a simple, commonly performed procedure which is very safe.

During your cataract operation, the natural lens inside the eye that had become cloudy is removed.  A new plastic lens is put inside the lens membrane (called the bag or capsule) in the eye.  In a small number of people, the capsule thickens after surgery and becomes cloudy. This interferes with the light reaching the back of the eye.  When this happens, the sight becomes misty, and some people may get glare in bright light or from lights at night-time.

Capsule thickening can happen as early as three months to few years after your cataract operation, but more commonly occurs about two years after surgery.  YAG laser capsulotomy is the only way to treat this.  Apart from affecting your vision, the thickening does not damage the eye in any way.  In YAG laser capsulotomy procedure the doctor applies a laser beam to the capsule.  Doctor may or may not use a special contact lens on the eye during the procedure to keep the eye open.  YAG laser beam creates a small hole in the centre of the capsule, which lets light through.

What are the benefits? 

The laser treatment is to remove the cloudy capsule thickening in your eye by making a small opening in the cloudy membrane behind the lens implant with YAG laser, which aims to restore your vision to how it was after your cataract operation.  Capsulotomy Improves clarity of vision provided, the rest of the eye is healthy.

Why do you need YAG laser capsulotomy treatment

In small number of the patients, capsule thickening can happen in three months after cataract operation, but more commonly occurs about two years after surgery, and vision becomes cloudy.  This interferes with the light reaching the back of the eye. When this happens, your sight becomes misty, and you may get glare in bright light or from lights at night-time. 

YAG laser capsulotomy is the only way to treat this. 

Are there any alternatives? 

An alternative to a YAG laser capsulotomy is to do nothing.  The capsule may or may not continue to thicken.  If it does, you may wish to consider a YAG laser capsulotomy at a later date.

Where is YAG capsulotomy performed?

The treatment is performed in the Outpatients Department as a day procedure.

What do I need to do to prepare? 

Since this is an outpatient treatment, you can eat and drink as normal.  You must continue to take any eye medication as normal on the day of the laser treatment (unless instructed otherwise). 

Asking for your consent 

We want to involve you in decisions about your care and treatment.  If you decide to go ahead, you will be asked to sign a consent form.  This states that you agree to have the treatment and you understand what it involves.  If you would like more information about our consent process, please speak to a member of staff caring for you.  No treatment is carried out without your consent.

Is YAG laser capsulotomy treatment painful?

No.  Laser treatment in the majority of patients is usually completely painless but sometimes may be a little uncomfortable. If this is the case please inform the doctor or nurse.

How long does a YAG laser capsulotomy treatment take?

YAG capsulotomy is an outpatient procedure and can take just minutes to perform, but you should allow up to 2 hours for your appointment.

Can I drive following this treatment?

No.  This is because dilating eye drops are used to open up the pupil(s) & your vision will be a slightly blurred for minutes or hours after the treatment. 

It is therefore advisable not to drive and to make alternative arrangements.

Do I need to be accompanied for my treatment?

Not necessarily.  However, you are advised to bring somebody with you, as dilating drops are used, & they can have a blurring effect on your vision. 

The effect of the dilating drops can in some cases, last up to 8 hours.

What will happen during treatment?

Present your appointment letter at the Clinic Reception desk where you will be booked into the Clinic.  The nurse will check your distance and near vision, so please bring your distance glasses with you.  You may have dilating drops put into your eye(s) (as requested by the doctor performing the treatment) to make the pupil(s) bigger, the black part of the eye, which can take around 20 minutes to dilate the pupil fully. 

An experienced eye doctor or a supervised doctor in training will carry out the YAG laser capsulotomy procedure.

You may have anaesthetic eye drops put in your eye(s) to allow the comfortable fitting of special contact lens onto the front surface of the eye(s).  This is to help to focus the laser beam onto the area to be treated.  It also helps to keep the eyelid(s) open.  This contact lens is removed at the end of the procedure. Once the lens is in place, you will see a bright light.  This allows the doctor to see the internal structure of the eye.  To carry out the YAG capsulotomy procedure, you will be asked to place your chin on the frame of the laser machine, which has a chin rest and handles for you to hold on to.  There will be a bright light shining into your eye(s) and you will hear a clicking noise, which is the noise of the laser machine being fired, you will not feel any pain.

The laser makes small holes in the capsule. These holes join up and this makes an opening in the capsule.

It is important that you keep your head and eyes still during the laser treatment, unless instructed otherwise by the doctor. 

Should you need to move your head, for whatever reason, please inform the doctor before doing so.

After the treatment

After the laser treatment, the eye will be temporarily ‘blind’ or ‘dazzled’ caused by the bright light emitted from the laser machine.  Your vision will gradually begin to return, usually in a series of colours, over a period of 5-10 minutes, but will remain blurred for 4-6 hours until the dilating drops wear off, if they were used.

Follow-up appointment

Most of the patients do not need any follow-up appointment, unless they have problems or need to be seen for other eye conditions. You may be given a date and time to be followed-up (before you leave), if requested by the doctor performing your treatment.

Care/ Restrictions after YAG capsulotomy procedure

There are no physical restrictions following treatment.  You can continue to have normal routine activity, but you are strongly advised not to drive on the day of procedure.  You can drive from the next day. 

Most of the patients do not need to take home any eye drops after the laser procedure. Pressure lowering drops are put in the eye after the laser procedure.

Some patients may need anti-inflammatory eye drops following treatment; you may be given a prescription to take to your local chemist to obtain anti- inflammatory eye drops, to be used for 

1-2 weeks, if the doctor feels they are necessary.

You may be given a single dose, in the form of a tablet after treatment to prevent any rise of pressure in the eye(s), if requested by the doctor.  This will be fully explained to you by the doctor if it is necessary.

You do not need antibiotics, as there is no open wound on your eye.

If you wish to see your optician for an up-to-date refraction (eye test) after having YAG capsulotomy laser treatment, you should wait for 1 week before doing so.  This will give your eye time to settle fully before seeing the optician.

Possible risks of YAG capsulotomy laser

Please read the following risks carefully.

Should any of these occur, we would recommend that you contact your optician/GP or present yourself to A&E.  There, your eye will be reviewed and you will be referred back to the Ophthalmology Department if necessary.

Inflammation

Any procedure carried out on the eye can cause inflammation.  This inflammation is usually quite mild, but you may be given a prescription for anti-inflammatory eye drops if requested by the doctor performing your laser treatment.

Elevated intraocular pressure

If a lot of laser power is required to perform the procedure, this can cause a temporary rise of pressure in the eye(s).  The doctor performing the procedure will decide, after completion of treatment, if it is necessary for you to be given eye drops or tablets to lower this risk.

Lens pitting

This happens if the laser beam causes scratches on the artificial lens implant whilst being focused on the thickened capsule. This is only a problem if the lens pitting occurs directly on the visual axis (in the line of your vision) which is very rare.

Floaters

For a few days or even weeks after the completion of the YAG capsulotomy laser treatment, you may be aware of “black cobwebs” or spider-like floaters in the eye.  They will, over time, become less noticeable, usually within a few days or weeks after the treatment.  These floaters are caused by the bits of debris formed from the opening made in the capsule.

Cystoid Macular Oedema (CMO)

This is a relatively rare complication.  CMO is the accumulation of fluid at the back of the eye (the retina) in the central area (the macula) due to leakage from blood vessels.  This in turn may cause a drop in central reading vision but can usually be treated should it occur.

Retinal detachment

This is a rare complication and more a risk in the myopic (short sighted) eye.  The symptoms of retinal detachment are:

• Flashing lights

• Sudden increase in the amount of floaters that persists over time.

• ‘Curtain’ coming down over the eye.

• Blank patch in the field of vision.

Advice after Laser Procedure

You can carry out all routines as normal.  No restriction of any activity unless been advised by doctor.

• If you experience discomfort, take painkillers e.g. paracetamol.  (No more than 8 in a 24-hour period).
• Your vision may be disturbed for up to 24 hours following the laser treatment e.g.  whilst the eye drops wear off.
• You may be aware of floaters in your vision. These should settle over the next few weeks.
• If you experience flashing lights or loss of vision, please contact the Eye Unit between 9am to 5pm Monday to Friday.  Out of hours contact your doctor or A&E.
• If you are on eye drops for any other eye problem, please continue to take them as advised.

Eye Services:

Telephone 01942 773271