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Exactly What To Expect With The Recovery After YAG Surgery

Exactly What To Expect With The Recovery After YAG Surgery

After cataract surgery, it is possible (and not all that rare) to develop a clouding of the capsule holding the new artificial lens. This is termed a posterior capsular opacification or more commonly known as an after-cataract. The treatment for this is a simple in-office YAG laser surgery known as a YAG capsulotomy. Did I mention that this simple? And fortunately, the recovery is also very simple and straightforward.

After YAG laser surgery, you can expect some blurry vision for the first few hours after the procedure. Much of this goes away once the eye dilation wears off. During the following week you can notice a few more floaters in your vision but this gradually subsides. And there aren't any additional restrictions after the procedure.

Pretty quickly after YAG surgery you can get back to your usual routine. So how is it that YAG surgery has such a quick recovery and no additional restrictions like cataract surgery?

How Does YAG Surgery Work?

Prior to cataract surgery, your cataract was contained within a capsule suspended within the eye. This capsule is the perfect spot for the new artificial lens and is thus preserved during surgery. But occasionally microscopic cataract remnants can grow along this capsule and cause it to become cloudy. This causes your vision to become more blurry. (see also Do Cataracts Grow Back After Cataract Surgery?)

Capsule of eye

Capsule of eye; image by File:Three Internal chambers of the Eye.png: Artwork by Holly Fischer derivative work: Pixelsquid, CC BY 3.0, via Wikimedia Commons / modified from original

But once you heal up from cataract surgery, the center of this capsule (the part that you look through) is no longer needed. This is where YAG surgery enters the picture.

Fun trivia knowledge: YAG stands for Yttrium aluminium garnet. This is a synthetic crystal. The rare earth element neodynium is “doped” or introduced into the crystal to create ND:YAG (or neodynium-doped yttrium aluminium garnet) and allows it to function as a laser medium - the part of the laser which amplifies the laser energy. This forms the ND:YAG laser used in YAG laser surgery.

This laser is able to focus precisely on the capsule and each application of laser energy causes a small disruption in the capsule. By applying these laser spots next to each other, a surgeon is able to create an opening within the capsule.

This is all done without any incisions in the eye. Your eye is simply dilated to allow the surgeon and laser to have a great view of your capsule.

There is also no pain as well! The capsule in your eye doesn't have any pain receptors. For some, the laser can just create a very mild popping or snapping sensation.

And a minute later, you are done. It truly is easy to have YAG laser surgery.

So What About The Recovery?

You don't have to wait a long time to recover after YAG surgery. In fact, much of the recovery will happen within the first few hours.

Initially (within the first few minutes) things can be very blurry after YAG surgery. Many surgeons will use a focusing lens placed on the eye to make the treatments very accurate and to hold back the eyelids. To provide a smooth surface for this contact lens, an ointment or gel is placed on the eye. These ointments and gels blur your vision! It will take minutes in order for your vision to start to clear up.

But the biggest thing to recover from is simply the eye dilation. Your eyes are dilated for YAG surgery. When your eyes are dilated, your vision can be a little more blurry. It will take about 4 to 6 hours for that dilation to wear off. (see also How Long For Dilated Eyes To Return To Normal?)

Once the dilation wears off, your recovery is essentially done (and with your cloudy capsule gone, your vision better). That's about it. Because the surgery doesn't involve any incision, there are no activity restrictions afterwards like there are after cataract surgery.

It is possible to have a small amount of inflammation after the procedure. Because of this it is common to take a steroid medication in order to allow this inflammation to resolve quicker.

Also, during the first few weeks after YAG surgery, you can notice a few extra floaters in your vision. These floaters are debris remnants of your capsule and will gradually fade away out of your vision.

What Can Delay Recovery?

YAG surgery is a very safe procedure, but there are a few conditions which can develop and delay the overall recovery.

It is possible to develop swelling in the retina in the back of the eye after YAG surgery. This can occur in approximately 1% of patients. Swelling or edema of the retina can cause additional blurry vision and require additional treatments to fix. This swelling won't develop immediately after the YAG procedure, it can take some time to develop.

And while you can have some normal floaters after YAG surgery, it is possible to develop abnormal floaters from a retinal tear with or without a retinal detachment. For those at risk for a retinal detachment (such as those who have highly nearsighted eyes), YAG surgery can increase the risk of developing a retinal tear or detachment. Retinal tears often cause flashing lights followed by the development of new floaters in your vision. These retinal tears if left untreated can cause the retina to detach which will cause a shade or curtain of vision loss. Retinal tears and retinal detachments are emergencies and need to be evaluated to prevent permanent loss of vision.

While it is good to be aware of these additional conditions which can delay recovery, fortunately these are rare after YAG laser surgery.

Summary

If you need YAG surgery to correct your vision after cataract surgery, you don't have to worry about having a lengthy recovery. During the procedure your eyes are dilated and much of the recovery is waiting for the dilation to wear off. There are no activity or water restrictions afterwards. Very quickly you can get back to your regular life.

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