YAG Laser Capsulotomy

If you experienced good vision following your cataract surgery, but are starting to experience one or more of the symptoms above (usually after about three months or more after surgery) then you need to get your eyes checked as soon as possible by your local optician, who will examine your eyes and conduct a sight test to check the quality of your vision. The optician will be able to refer you to SpaMedica or another specialist, depending on what treatment you require.

As you will know, as a previous cataract patient, you can choose the provider/hospital you would like to receive your treatment at. If you choose SpaMedica as your provider please let your optician know which of our hospitals is most convenient for you.

You will need to let your optician or GP know which healthcare provider and hospital you would like to go to and they will then send a referral to your chosen provider. You should hear back from your provider within two to three weeks following your referral.

Your chosen hospital/provider will contact you by phoning or sending a letter to book an appointment. Our SpaMedica Referrals team calls each of our patients within 2 to 3 days of us receiving your referral. We talk through the next steps with you, answer any questions you may have and you choose an appointment date to suit you.

You will receive written confirmation of your appointment date and information on the YAG Capsulotomy treatment. SpaMedica provides a comprehensive patient information booklet on YAG Capsulotomy, which includes what you can expect at each stage of your patient journey. You can download a copy of this booklet by clicking here.

The purpose of your first appointment at the hospital is to run a thorough check on your eyes to confirm that YAG Capsulotomy is the best treatment for you. Several eye tests will be conducted, with your appointment lasting about 1 to 1.5 hours (which includes about 30 to 40 minutes to allow your pupils to dilate – see ‘part 4’ below).

Dilating the eyes causes blurred vision and sensitivity to light, so you won’t be able to drive; so it’s important to make sure you organise a lift or arrange transport to/from the hospital. SpaMedica provides free transport for some patients, based on your location and other criteria – if you’re struggling to find transport please speak to a member of our Referrals team to see if you qualify for free transport.

Please feel free to ask any questions you may have about your treatment with the nurse and/or optometrist – see ‘steps 7 and 8’ below.

You’ll need to bring your current glasses, a list of your current medications, record book (if you’re diabetic or taking Warfarin) and a contact number of a relative/friend. If you wear contact lenses these should be removed just before your appointment.

So what will happen at this appointment?

1. Welcome – You will be welcomed and signed in by one of our friendly reception team members and directed to the assessment clinic. You will be seated in our clinic reception and offered complimentary tea, coffee and biscuits.
2. Vision test – The first test we conduct is to check your vision, this is done using a chart, the same as used in opticians, where we ask you to read letters from the top line downwards on the chart.
3. Eye pressure – It is important to test the pressure in each eye to check eye health and test for glaucoma. Anaesthetic drops will be placed in each eye before the eye pressure test, which is conducted using a handheld meter, which gently touches the surface of the eye and provides a digital readout of the pressure in the eye.
4. Pupils dilated – Drops are placed in each eye to dilate the pupils (this makes your pupils larger, so we can examine the eye). It usually takes about 30 to 40 minutes for your pupils to dilate and then we can examine your eyes. Dilating your pupils affects your vision and sensitivity to light for up to four hours, so you will not be able to drive yourself home after the appointment. And, of course, you will be offered more complimentary tea, coffee and biscuits while we wait for your pupils to dilate.
5. Eye diagnostics – We run a diagnostic test that takes a magnified colour photo of your eye and check the general health of your eyes.
6. Additional tests (if required) – A few patients require some additional eye tests at their pre-operative assessment – for example, for those with pre-existing eye conditions or previously had laser treatment. These include imaging tests; one takes a cross-section image of your retina and the other measures and checks the shape of your cornea.
7. General healthcare – One of our friendly SpaMedica nurses will conduct a routine blood pressure test and temperature check. They will discuss your current health and what regular medication you are taking (both prescription and non-prescription). They will also talk through your YAG Capsulotomy treatment and what will happen on the day of the procedure, explaining everything thoroughly and answering any questions you may have.
8. Optometrist check – All your test results are checked and analysed by a SpaMedica optometrist (eye healthcare specialist). They check to make sure that YAG Capsulotomy is suitable for you and will discuss the benefits and risks of the treatment. If both your eyes require treatment the optometrist will talk about which eye we would recommend to treat first, this is usually the eye with the worst vision, but the optometrist will discuss this fully with you to find out the best option for you.
9. Consent – We take time to discuss with each of our patients the details of your YAG Capsulotomy procedure, the benefits that you should get from the treatment and also the risks. We’ll check that you understand everything and ask you to sign a consent form, which lets us know you give your permission for the treatment to go ahead. Please let us know if you have a lasting power of attorney (LPA) or require support for giving consent.
10. Booking your treatment date – The final stage of your appointment is to book a date for your YAG Capsulotomy. Our receptionist will give you available dates and you can choose a time and date to suit you.

The YAG Capsulotomy procedure is straightforward; there are no needles or eye clamps, the laser treatment takes about 30 seconds and you will be sat up for this, there is no need to lie down.

Advice and recommendations for treatment

• The time given for your appointment is the time you should arrive at the hospital and NOT the time of your treatment – arriving earlier will mean a longer wait for you
• Please arrange transport to and from the hospital – your eyes will be dilated during the appointment and this causes blurred vision and sensitivity to light, so you won’t be able to drive; so it’s important to make sure you organise a lift or arrange transport. SpaMedica provides free transport for some patients, based on your location and other criteria – if you’re struggling to find transport please speak to a member of our Referrals team to see if you qualify for free transport
• We recommend eating a light meal before you arrive at the hospital
• Please take all your medications as normal, unless we have specifically advised you not to
• You should wear comfortable and loose fitting clothing – you will not need to wear a hospital gown
• It’s OK to wear make-up for your appointment

And here’s some detailed information about what to expect during your treatment appointment – all the SpaMedica team are here to support you, make you feel at ease and make your time with us as stress-free as possible.

1. Welcome – You will receive a big smile and warm welcome from one of our friendly reception team. They will check you in and take you to the patient waiting area. You will be offered complimentary tea, coffee and biscuits for you and your family/friends/carer.
2. Arranging pick up – Our reception team will ask contact details of the person who will be picking you up after your treatment and we will give them a ring when you’re ready to go home. Your family/friends/carer is also welcome to wait in the reception area once you are called through to the treatment room – this is normally about a 1 to 2 hour wait.
3. Pre-treatment – One of the nurses will call you through to the pre-treatment room and pop some drops in your eye to dilate your pupil.
4. Clinic reception – We’ll ask you to wait in the clinic reception while we’re waiting for your pupils to dilate, usually about 10 to 20 minutes.
5. Your treatment –
   1. You will be called through to the treatment room once your pupils are dilated.
   2. The treatment will be performed one of our experienced Optometrists or Specialty Doctors, who will welcome you and explain the next steps.
   3. You will be sat in a chair (or you can stay in your wheelchair). The Optometrist/Doctor will ask you to rest your chin on a bar. This is a similar position to the one you will have been in when you had your eyes checked at the opticians.
   4. You will look straightforward and see a bright light.
   5. The Optometrist/Doctor will deliver a burst of laser to the centre of your pupil – this only takes about 30 to 60 seconds.
   6. Treatment all done – take a deep breath and smile!
6. Time to go home – we’ll call the contact you gave us to organise a lift home, if they’re not already waiting for you in the reception area. If you have organised a lift on our SpaMedica bus, you’ll be booked in with the driver, who will come and get you when the bus is ready to go.

It is usual for your vision to be blurred following the treatment, with the majority of patients seeing an improvement in their vision within 24 hours.

You may also experience floaters after the surgery and these should resolve within a few weeks.

You can go back to your normal daily activities the day following treatment, including driving.