YAG Capsulotomy Technique

March 7, 2009

I was trained to make a cruciate- like capsulotomy- starting in the center and making a radial incision vertically then horizontally using the YAG. When I started using silicone lenses, I sometimes pitted the lens. Also, one patient had a capsulotomy done elsewhere and was very angry about the floaters. So I started doing capsulotomies by aiming in the periphery and making a circular opening. At the bottom, I elected not to complete the capsulotomy but left intact about a millimeter or two. This way, I was left with a flap instead of an “operculum”, and thus I reduced greatly the amount of debris. The capsular flap always shrivels up and stays out of the visual axis (though, once it did not and I had to do a little more laser). I think this is the way to go.




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One Response to “YAG Capsulotomy Technique”

  • maricor concep

    I recently had yag capsulotomy on both eyes and my cataract surgeon used what I believe to be the same technique you mentioned (hinge). The piece of attached capsular membrane is mobile and keeps flapping in and out of my visual field with eye movements, mostly looking down and up (computer work) as expected. This membrane causes fogging and glare around light. My question is how long does it normally take for hinged membrane to shrivel and shrink before opting for a secondary laser touch up? This will probably cause floater so would rather take the natural approach.

    Also, while gravity will probably help in resolution of the hinged capsule, it also causes new flaps to develop in the upper capsular opening. So when looking straight ahead, I see remnants of the capsule membrane hanging, semi-mobile above my line of vision. This causes moving small radial glare that can sometimes be blinked away. Will this also shrink up and fold away in time? Will the capsular opening enlarge in time so I will not notice the membrane anymore?

    How should I plan to resolve these issue?

    It looks like the last post was a while back but hoping to get a response anyway.