YAG laser capsulotomy

What is posterior capsule opacification?

Many will have heard people say “my lens got dirty” after having had cataract surgery. However, even though it is a very commonly used expression, even sometimes by professionals themselves to help patients understand, it is not completely accurate.


Pseudophakic intraocular lenses implanted during surgery for presbyopia and cataracts as a lens replacement, are completely customised to each patient and made of a biocompatible material, which means that they do not interact with the components of the eye, nor do they degrade or change over time. Intraocular lenses remain in the same condition from the first day until the last after implantation.


So, what is “cleaning the lens”? To understand this, we first need to understand how surgery for presbyopia and cataracts is performed. The lens is inside a membrane consisting of an anterior capsule and a posterior one. During surgery, the lens is not removed as a whole. Instead, a circular opening is cut in the anterior capsule to access the inside and remove the nucleus of the lens, leaving the posterior capsule intact. By extracting the nucleus of the lens, there is an empty membrane where the lens is implanted. It is the posterior capsule of this membrane that opacifies over time due to scarring and fibrosis and it is on that membrane that we need to act in these cases.

Does the procedure need to be repeated?

To solve posterior capsule opacification, a capsulotomy is performed using YAG laser. Essentially, a small window is opened in this capsule in a precise and controlled manner, so it does not need to undergo treatment again as the fibrosis disappears.


The time when posterior capsular opacification appears varies greatly depending on the type of surgery, intraocular lens and inherent characteristics of each patient, and it may develop a few months post-surgery or perhaps even many years down the line. Nevertheless, regardless of the time of onset, in most cases it will take 3 to 6 months post-surgery before action can be taken.


At CLÍNICA RAHHAL, we have the most advanced technology in the ophthalmology sector and state-of-the-art equipment.

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Select one of the following FAQs from our patients to show the answer. If you cannot find the answer to your question, please contact us using the form below.

Does an intraocular lens get dirty?

No. Even though we often talk about “needing to clean the lens”, this is no more than a simple way of speaking so that patients easily understand. Intraocular lenses are made of sophisticated materials to remain intact over time. What we “clean” is the membrane into which this lens is inserted.

Why does this membrane get dirty?

This capsule tends to opacify over time due to a fibrous reaction, which is completely normal after surgery.

Does it happen in all patients?

Yes, all patients operated on with intraocular lenses for presbyopia or cataracts will at some point present with posterior capsule opacification. It is therefore considered normal in the post-surgical period. However, the degree of opacification or fibrosis will vary from one patient to another. This will mean that symptoms appear in some cases (loss of vision quality) and not in others, as its progression will vary.

Must it always be treated?

Not always, as it will depend on the degree of fibrosis and progression. In other words, if there is a small degree of opacification, there will be no vision symptoms and treatment will not be needed, although supervision at eye check-ups will determine whether it is needed at some point.

Is it performed in an operating theatre?

No. A capsulotomy is a procedure that is performed using YAG laser in a consulting room. It is important to stress that this laser is nothing like those used to treat refractive issues (myopia, hyperopia or astigmatism).

Is the procedure painful?

No. The procedure is performed in the consulting room itself and barely takes five minutes. No sedation, stitches or post-procedure rest are needed. It is a very quick and very routine procedure in ophthalmology consulting rooms.

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