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 Encyclopedia - Capsulotomy

When is a capsulotomy needed?
What are the types of capsulotomies?

A capsulotomy is an incision that opens the clear, cellophane-like capsule that wraps the natural crystalline lens of the eye (See Anatomy of the Eye). The lens is surrounded by the capsule and separates it from the vitreous, which is the thick fluid in the back of the eye, and the aqueous, which is the thinner fluid in the front of the eye.

When is a capsulotomy needed?

A capsulotomy is sometimes necessary following cataract surgery. A cataract occurs when the natural lens of the eye becomes clouded, usually as the result of aging. It is treated by surgically removing the clouded lens and replacing it with an artificial prescription lens. During cataract surgery, the front, or anterior, portion of the lens capsule is removed at the same time that the natural lens is removed. It is then replaced with a plastic prescription lens. The rear, or posterior, portion of the capsule is left in place.

In 30 percent to 40 percent of patients, the posterior capsule becomes cloudy following cataract surgery. The cloudiness can appear months or years after surgery. The main symptom is a decrease in vision. Another symptom is difficulty with glare and bright lights. If the cloudiness impairs vision, you will need a posterior capsulotomy. Patients sometimes mistakenly think the cataract has come back, but it cannot return because the natural lens of the eye has been removed.

What are the types of capsulotomies?

A posterior capsulotomy is a laser surgical procedure that uses a YAG laser to create an opening in the center of the clouded posterior capsule. The opening allows light to pass freely to the retina, thereby improving vision. The procedure is painless and takes less than 5 minutes in the ophthalmologist's office. It does not involve anesthesia, other than numbing eye drops, and you will notice an improvement as soon as your dilated pupil returns to normal size.

As with any surgery, rare complications can occur. With a posterior capsulotomy, there may be swelling. People who have a YAG laser capsulotomy are at a slightly higher risk of developing a retinal detachment in the future. In very rare cases, the intraocular lens can dislocate through the opening in the capsule, requiring surgical repositioning or replacement.

An anterior capsulotomy is a cataract surgery technique used to make a small round opening in the front of the capsule that contains the eye's natural crystalline lens. Through this opening, the ophthalmologist inserts a tiny instrument to break up and remove the cloudy lens. It is then replaced with a plastic prescription lens.

Related topics:


See Eye Exam Types in Eye Health Center.
See Free Eye Tests.

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