What Is Posterior Capsular Opacification (PCO)?
Posterior capsule opacification (PCO) is the most common complication of cataract surgery.
During the phacoemulsification, the surgeon opens a portion of the anterior capsule (capsulorhexis) to remove the cloudy lens inside your eye. Then, he places a synthetic lens into the intact capsular bag.
PCO occurs when residual lens epithelial cells (LECs) on the residual anterior capsule migrate and grow over the back (posterior capsule), causing it to thicken gradually.
The membrane also becomes hazy and cloudy. This means that light is less able to travel through to the retina (at the back of your eye), causing adverse effects on your vision.
Sight can become blurred and cloudy.
Posterior capsular opacity presents in two forms, fibrous and pearl (also called proliferative).
- Fibrous PCO presents as wrinkles and folds on the posterior capsule. It is located at the site of fusion of the anterior and posterior capsules.
- Pearl PCO accounts for the majority of vision loss PCO cases. It is composed of normal LECs that occupy the equatorial (middle) lens region. Microscopic examination shows clusters of swollen and opacified LECs called bladder or Wedl cells.
If you had cataract surgery in both eyes, posterior capsular opacification could affect both of them. But each eye may be affected at different times.
A better understanding of the pathophysiology of PCO has led to modifications in surgical techniques and intraocular lens designs to decrease its development.
Certain lenses used in cataract surgery may lower this risk and the need for laser capsulotomy later.
YAG Laser Capsulotomy
Laser treatment for PCO is performed using a very low-energy laser called neodymium: YAG “Nd: YAG,” sometimes referred to as just “YAG.”
The YAG laser can delicately make a hole on the thickened lens capsule without damaging other parts of your eye. Because the laser can travel through the cornea without cutting it, there is no risk of infection from this treatment.
The procedure is a quick, painless, and effective treatment for posterior subcapsular cataract.
Delaying laser capsulotomy is unlikely to cause long-term effects to your eye or make the procedure more difficult. However, you should consider this procedure if PCO seriously affects your vision and quality of life.
You will generally only need laser treatment for PCO once.
Very rarely, patients may develop re-opacification of the posterior capsule. Also, the opening in the capsule made by the first laser treatment could shrink, causing PCO to come back.
If this happens, it is possible to safely have further laser treatment if needed. Also, if you have PCO in both eyes, it is possible to have laser capsulotomy for both on the same day.
Laser capsulotomy is the preferred treatment for posterior capsular opacification in older children and adults. Rarely, it is treated with surgical capsulotomy.
What are the Possible Complications from YAG Laser Capsulotomy?
For some patients, laser treatment for posterior capsular opacification can cause short-term increased eye pressure. This can be an issue if you already have glaucoma, as your eye pressure may already be higher than normal.
If your ophthalmologist is concerned about this, he will check your eye pressure soon after the treatment. And if your eye pressure has increased, you will receive eye drops or tablets to lower it down.
The treatment can rarely cause retinal detachment, where the nerve layer (retina) lifts from the back of your eye. This can happen days, weeks, or months after capsulotomy. It is more likely if you are very short-sighted.
Remember that these risks are extremely rare complications of the YAG laser treatment. The majority of patients get excellent outcomes without experiencing any issues.
How much does YAG Laser Capsulotomy cost?
If you want to know YAG Laser Capsulotomy cost, please, fill in the contact form. If you have any medical reports or examination results from other centers, we would appreciate it if you could send these tests to us by email.
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YAG LASER CAPSULOTOMY SPECIALISTS AT BARRAQUER EYE HOSPITAL:
External links – Bibliography
Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy. Montenegro GA, Marvan P, Dexl A, Picó A, Canut MI, Grabner G, Barraquer RI, Michael R.
Nd:YAG laser diascleral cyclophotocoagulation: survival analysis after four years. Barraquer RI, Kargacin M.
Neodymium:YAG laser iridotomy as a possible contribution to lens dislocation. Melamed S, Barraquer E, Epstein DL.
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