All About Dirty Intraocular Lenses: Capsulotomy
Table Of Contents
As we learned in 7 Questions About The Crystalline Lens, we have a crystalline lens inside our eye. This natural lens allows us to focus on objects as they approach us.
As our body ages, so does our crystalline lens, which becomes more opaque as it loses its transparency and elasticity.
As we saw in 4 Questions About Cataract Surgery, the only solution so far to treat the opacity of the crystalline lens is cataract surgery.
It is a straightforward procedure and is performed on an outpatient basis. The crystalline lens is removed from the eye and replaced by an artificial intraocular lens placed in the same place where the crystalline lens was located, in the posterior capsule.
A sachet that remains intact when the lens is removed holds the new artificial lens in place.
But what happens when sometime after the cataract surgery, we notice blurred vision again?
The intraocular lens is dirty and feels like seeing through fogged glass.
This does not mean that we have cataracts again since the crystalline lens was removed from the eye.
Although previously known as a ‘secondary cataract,’ it is a posterior capsular opacity PCO issue. (the sack where the intraocular lens was placed).
What can we do to ‘clean the dirty intraocular lens’?
Why does the intraocular lens become dirty?
As stated by the American Academy of Ophthalmology AAO, after cataract surgery, some cells may be left behind after removing the lens.
These remaining cells grow as the months and years go by and grow on the posterior capsule of the intraocular lens.
This causes the intraocular lens to thicken, wrinkle, or become more opaque, and vision becomes blurred.
What Is An Eye Capsulotomy?
Eye capsulotomy refers to the procedure used to treat posterior capsule opacity issues. In other words, it is a procedure that cleans the intraocular lens.
How Is The Intraocular Lens Cleaned?
o clean the intraocular lens, the ophthalmologist uses an Nd: YAG laser, which opens the posterior capsule to allow light to re-enter the retina.
How Is Capsulotomy Performed?
Capsulotomy, as explained by the AAO, is performed in the ophthalmologist’s office. The doctor dilates the pupil and anesthetizes the eye with the soiled intraocular lens to accomplish this procedure.
Then, using a laser, he targets the posterior capsule area to make an opening.
Thanks to the opening made in the posterior capsule, light can enter again easily since the intraocular lens will have been ‘cleaned’.
After a capsulotomy, everyday activities, including driving, can be resumed.
However, the ophthalmologist will tell us what we cannot do or if we need some drops during the following days.
How long does the capsulotomy last?
The duration of the Capsulotomy is short, just a few minutes, and it is a painless procedure. However, we must remain under observation for about 1 hour to check the eye pressure.
What are the Risks of A capsulotomy Procedure?
Like with most interventions, there are some risks after a capsulotomy procedure:
In Veterans Health Library, they show us what some of these risks are:
- Increased eye pressure
- Inflammation for a short period of time
- The laser can tear the intraocular lens.
And in rare cases:
- The lens may move or shift out of place – Retinal detachment
For a more technical explanation of the protocol to follow in an Nd:YAG capsulotomy and the indications and guidelines for follow-up and treatment, please check this interesting link from the Ophthalmological Society of Madrid.
Remember to go to the ophthalmologist in case of consultation or any situation, as they are the person who will be able to help you best.
To finish, we want to do it with the following video, where we can get more information about the capsulotomy procedure in the eye:
And a study, which was conducted between January 2010 and January 2011 with patients at the Hospital General Universitario de Cienfuegos on the Impact of laser capsulotomy on their quality of life with posterior capsule opacity after cataract surgery.