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Posterior Capsular Opacification

Posterior Capsular Opacification (PCO) is a common complication after cataract surgery. PCO occurs as cells remaining after cataract surgery grow over the back of the bag that houses the new artificial lens. It’s essentially the healing process of the eye building up scar tissue. The effects of PCO are very similar to symptoms of cataract with blurred/cloudy vision or glare. Patients often state their vision is ‘milky’.

Treatment

Treating PCO is common and straightforward and happens in the outpatient department using a state of the art class 4 laser. The procedure takes about 1 minute and is painfree and minimally invasive. Its not like having your cataract operation but more like an outpatient examination.

This is a one-off laser treatment and allows your vision to return to normal within a day or so.

Patient treatment timeline

DAYS Optometrist Community Eyecare
DAY 1 Referral following assessment
DAY 3 Community Eyecare Referral management
DAY 13 Booked appointment ‘one stop shop’
DAY 17 Optometrist review for refraction Spectacle prescription as required

Frequently Asked Questions

What is Posterior Capsular Opacification?

When you undergo cataract surgery, the new lens is placed carefully in the ‘bag’ that held the old natural lens in place. In about 1 in 10 patients, this ‘bag’ begins to scar to a degree that the ‘bag’ becomes cloudy and makes seeing difficult and misty. It’s a bit like when you cut yourself, a scar forms. The ‘Posterior Capsular Opacification’ is essentially scar formation.

What is the purpose of YAG laser treatment?

The purpose of a laser treatment (capsulotomy) is to create an opening in the cloudy membrane in order to restore vision. This provides a clear passage for

What happens before the day of treatment?

You will have received the information leaflet on YAG laser treatment which you should read. You will also have eyedrops sent to you to instill in the eye to have the laser a minimum of 30 minutes before you arrive.

What happens on the day of treatment?

This is nothing like your cataract operation, but more like a consultation. You will be in and out without realising anything has been done! The nurse will check you vision and answer any questions, who will then hand you over to the clinician. Before agreeing to undergo laser treatment you will need to sign a consent form signifying that you understand the risks and benefits of the procedure. We encourage you to ask any questions which may arise before signing the consent form.

What are the intended benefits of the laser?

In essence, the goal of laser is to improve your vision back to the level it was after you had the cataract removed. If you suffer other eye problems, the vision may not improve as much as we would like.

What are the risks of laser treatment?

As with any procedure, laser treatment has risks. An improvement in eyesight cannot be guaranteed. Serious complications are however rare but include:
  • Retinal detachment – the retina, which is the inner lining of the eye, can become detached. If untreated, this can lead to reduced or complete loss of eyesight, but if detected early it can usually be successfully treated. This happens in 1 to 2 in 100 patients
  • Macular oedema – the retina can become swollen causing blurring of vision. This can be treated medically but may take several weeks to improve. The chance of macular oedema after laser capsulotomy is 1-2%, but may be higher in diabetic patients.
  • Worsening of glaucoma or causing glaucoma (raised pressure) in the eye. This usually can be medically treated and has an incidence of 1.5% after capsulotomy.
  • Rarely the lens may be damaged by the laser causing visual problems. In exceptional circumstances, the lens may subsequently need to be changed.
  • Very rarely, additional medical or laser treatment may be needed after the procedure to obtain the best vision.

How is the procedure carried out?

  • Your vision will be checked, so please bring your glasses with you.
  • Drops to dilate your pupil will be put into one or both eyes, which will blur your vision for several hours.
  • You will not be able to drive home after the drops, so please bring a companion or make suitable transport arrangements
  • The procedure is performed with the laser machine connected to a normal slitlamp (microscope).
  • A contact lens is placed on the eye to focus the laser beam and keep the eye open.
  • The procedure lasts approximately 5-10 minutes, during which time you will hear beeping noises and experience bright lights.
  • There is minimal discomfort, if any.

What happens after the YAG laser and when can I drive again?

  • Your vision will be blurred after the treatment, but should improve over the following few hours.
  • If you experience a sudden shower of floaters, flashes of light in the eye, or the feeling of a curtain coming over your vision, you should contact the Community Eyecare on the number provided as this may indicate a retinal detachment
  • You should also contact the eye unit if you experience severe pain or loss of vision after the laser treatment.
  • Certain patients will require follow-up appointments in the outpatient clinic. Before you leave, the laser operator will advise you whether another appointment is needed.
  • You may resume driving the following day
  • You may visit the optician a week after the treatment to check if your glasses need changing.

Making a referral

Posterior Capsular Opacity Information leaflet

01772 717167 - General

01772 795620 - Secure Fax / Safe Haven

customerservices@communityeyecare.org.uk- Appointments & Information

For General Enquiries use our secure Contact Form