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Blurred vision years after cataract surgery: do I need a YAG laser?

Many people see clearly after cataract surgery, then find, a year or a few years later, that their vision is slowly becoming hazy again, with glare like before. They often fear the cataract has come back. It has not: a cataract cannot grow again once the natural lens has been removed. The usual cause is clouding of the capsule behind the new lens, and it is treated with a short laser procedure. For an overview of cataract care, see cataract surgery in Vasco, Goa.

Why does vision blur again after cataract surgery?

During cataract surgery, the cloudy lens is removed from inside its capsule, a thin clear bag, and the artificial lens is placed in that bag. The capsule is left on purpose, because it holds the new lens steady. But a few lens cells can remain on the capsule, and over months or years they can grow across the back of it, making it hazy. This is called posterior capsule opacification (PCO), often known as after-cataract or a secondary cataract.

It is common, it can happen after either phaco or SICS, and it does not mean anything went wrong with the surgery. The signs are much like the original cataract:

• Vision slowly becoming blurred or misty
• Glare from sunlight and haloes around lights at night
• Difficulty reading, even with your spectacles

How is it diagnosed?

Our eye surgeon examines the eye under a microscope, usually after drops to widen the pupil, and can see the cloudy capsule behind the lens. Other causes of blurred vision after cataract surgery are checked as well, such as a change in spectacle power, dry eye, or swelling or other problems in the retina, because these need different care. See eye check-up in Vasco.

What is YAG laser capsulotomy?

YAG is the name of the type of laser. Capsulotomy means making an opening in the capsule. The laser makes a small, clear, round opening in the centre of the cloudy capsule, so that light can pass straight through to the retina again. There is no cut, no stitch and no injection, and the artificial lens stays where it is.

What happens during the YAG laser procedure?

1. Drops are put in to widen the pupil, and numbing drops are put in the eye.
2. You sit at the laser machine, which looks like the microscope used in an eye check-up, with your chin on a rest.
3. A special contact lens may be placed gently on the eye to steady it and focus the laser.
4. You look at a target light and keep still. You may hear clicks and see flashes of light as the laser works.
5. The procedure itself usually takes only a few minutes.

Your eye pressure may be checked afterwards, and you may be given drops to use for a few days.

What will I see and feel afterwards?

Most people feel little more than the contact lens touching the eye and some brightness from the light. Your vision is blurred for a few hours because of the dilating drops, so come with someone and do not drive. Vision usually clears within a day or so. You may notice small floaters, specks of the opened capsule, which usually fade over days to weeks. Most people return to normal activities the same day or the next.

Are there any risks?

Problems after YAG laser are uncommon. They include a short-term rise in eye pressure (which is why it may be checked), mild inflammation, swelling at the centre of the retina, and rarely retinal detachment. Call at once, day or night, if you notice increasing pain, worsening vision, flashes of light, a shower of new floaters or a curtain over your vision. Emergency eye care at ReNew Vision is available 24 hours; see eye emergency.

Will the clouding come back?

Once a clear opening has been made, the clouding usually does not come back, because the opening stays open. Most people need YAG laser only once in each eye, if at all. Other changes in vision later in life, such as needing a new spectacle power, have other causes and are checked in the usual way.

Is the YAG laser the same as LASIK?

No. LASIK reshapes the cornea to change spectacle power. The YAG laser used after cataract surgery simply opens the cloudy capsule; it does not change your spectacle power much, and it is not used to remove a cataract. After YAG laser, your spectacle power may be rechecked once the eye has settled.

Can I have YAG laser if my cataract surgery was done elsewhere?

Yes. ReNew Vision does YAG laser in Vasco. Bring your cataract surgery papers, discharge card or lens details if you have them, and your current spectacles. If you are also wondering about your lens or your follow-up care, read precautions after cataract surgery.

To book, call or WhatsApp ReNew Vision Eye Hospital on 072489 88039. The eye OPD in Vaddem, Vasco da Gama is open Monday to Saturday, 4 pm to 7 pm.

Questions patients ask

Is YAG laser painful?

Numbing drops are used, so most people feel little more than the contact lens touching the eye and some brightness from the light. There is no cut or injection.

How long does YAG laser take?

The laser itself usually takes only a few minutes. With drops to widen the pupil beforehand and a pressure check afterwards, plan for a visit of an hour or two.

Is after-cataract the same as the cataract coming back?

No. A cataract cannot grow again once the natural lens has been removed. After-cataract is clouding of the capsule behind the new lens, and a YAG laser opening clears it.

Can I go home after the YAG laser?

Yes, usually straight after. Because the pupil is widened, your vision is blurred for a few hours, so come with someone and do not drive.

Why do I see floaters after YAG laser?

Small pieces of the opened capsule can float inside the eye for a while. They usually fade over days to weeks. A sudden shower of floaters, flashes or a shadow over vision needs urgent care.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.