Southwest, FL | Case of the Day- Yag Laser Treatment | Cataract & Refractive Institute of Florida

Dr. Croley discusses Yag laser treatment for treating an after cataract or clouding of the posterior capsule. The capsule holds the natural lens in place inside the eye and is used to hold the implant or intraocular in the eye.


Dr. Croley: Hello, I'm Dr Crowley and welcome to Case of the Day. Today we're going to discuss a surgical procedure and question I get asked a lot and we just did several of these cases yesterday and so thought I would go over that. So after someone's had cataract surgery, then sometimes the capsule that sits behind the implant can cloud up and that's called a pacification of the pusher capsule or after cataract. And so people want to know when their vision blurs after they've had cataract surgery, what's happened, and so we're going to go over that. So when we do cataract surgery, your lens, that is this lens behind your pupil, gets cloudy. This lens is held in place from this little ciliary body. There's little ligaments that go from this body over to your lens, holds the lens in place in your eye, and there's a capsule that surrounds your lens.

Dr. Croley: So when we do cataract surgery, we cut an opening in this capsule about the size of your pupil. So that way we can get the cloudy lens material out and then a lens or interocular lens is placed back inside this same capsule. So now this artificial lens sits right in the same area. What happens over time is there's microscopic little cells that line this capsule and over time those cells can cause fibrosis and scarring. And now the back of the capsule now becomes cloudy. And so when that happens then that blurs your vision just almost exactly like a cataract would. And so the treatment for that is called a YAG laser, "Y-A-G", YAG laser. So a laser beam is aimed at the back of the capsule and we cut an opening in the back of this capsule about the same size as the front opening.

Dr. Croley: So now there's a clear shot from the front of your eye all the way through the lens, the capsule, all the way back to your retina. And that clears your vision. The procedure takes 30 seconds, a minute or so, very quick and simple. And so it is something that occurs with today's lenses and techniques. Maybe in your lifetime, you may get this capsule to cloud up maybe 20% to 25% of the time, depending on the type of lens and whatnot. The YAG laser is a unique system that was developed in ophthalmology. A laser is a focused beam of light of one wavelength. So this light is a red laser. So this is a laser pointer. And so this is one wavelength of the spectrum of light. And it's very weak, so it's not burning or doing anything.

Dr. Croley: And so that's what a laser is, is a focused beam of light. So different wavelengths have different properties. Some of the wavelengths, if they have enough power, will burn something when you aim it and other lasers cut things. They are called a cold laser, there's no heat generated. And so you get to choose what wavelength to do different things that you want to accomplish. So a YAG laser is a cold laser, so it cuts this capsule without causing any burning or heat. It actually is so powerful that it actually rips electrons off the atom. So it vaporizes whatever it does, just like you see on Star Wars, where did they shoot the laser gun and those people disappear. That's sort of what this kind of laser does. And in fact, this laser is now being used by the government, the armed services, and these are going to be weapons.

Dr. Croley: And so they're now, I was told by someone just recently, they're putting these laser weapons on the ships. And when I was in Europe back in Berlin and in London back in the early '90s when LASIK and PRK was first coming out, I was over there studying the laser and after the Gulf war, the head of the International Laser Society told us that we actually had different laser weapons in the war because there was no press allowed in the first Gulf War and that these things were powerful. Well, I mean you see what happens to the eye, so a very weak laser. But if you had a big powerful generator unit, it could be a very destructive laser. And that's also the Star Wars thing about the fish.

Dr. Croley: You can shoot this laser and shoot a missile out of the air and it's also the same laser that they use when you've seen these war movies where the bomb goes in through a window, that they can guide the bomb through a window. They're actually using a YAG laser as the guidance because they're so accurate. So if you have had cataract surgery and your vision starts to cloud up, then there's a very good chance that that capsule is clouded up and that's a very simple, easy procedure to do to fix that. There's not something wrong... that the doctor did something wrong in the case that this fibrosis happens no matter what is a certain percentage of patients.

Dr. Croley: And so there's not a problem, easy to fix, so don't need to be concerned, that concerned about it. If you're having vision trouble, get to see your eye doctor so you can get it taken care of. So if you have any questions about a YAG laser and an after cataract or clotting of your posterior capsule or anything else, you can always contact us through the website. We'd be happy to try to answer your question. If not, may God grant you healthy eyes and great vision.