Capsulotomy (ophthalmology)

The capsulotomy (also Nd: YAG laser capsulotomy ) is a laser treatment method in ophthalmology . It is used after cataract operations if a so-called cataract has occurred on the back of an implanted intraocular lens (artificial lens) . This is caused by clouding of the lens capsule remaining in the eye or by the deposition of cells (regenerates) or fibrotic material and usually leads to a reduction in visual acuity. In the vast majority of cases, a capsulotomy is performed with the help of an Nd: YAG laser , whereby the rear part of the lens capsule is opened using several laser pulses with the aim of creating a sufficient eye gap for better visual function.

Surgical capsulotomy

In rare cases, e.g. B. children, with a purely regenerative cataract or with patients who are not able to stand still in front of the slit lamp , the capsule can be surgically divided by paracentesis with a needle, possibly combined with suction of the regenerated material (in children) or as part of a vitrectomy .

Risks

If the laser is focussed incorrectly , the artificial lens can be damaged, creating depressions in the lens, so-called pits. These are usually not noticeable to the patient. Remains of the capsule in the vitreous cavity can lead to subjectively disturbing cloudiness when they by in some cases face line move. If necessary, one is here Vitreolyse with an Ellex laser necessary. Corneal damage and cystoid macular edema are other known, albeit rare, risks.

In rare cases, post-cataract laser surgery can lead to retinal detachment (ablatio retinae). Temporary increases in intraocular pressure have also been described. Therefore, regular ophthalmological checks are recommended as a result.

Individual evidence

1. ↑ Guideline No. 19b (Nd: YAG laser capsulotomy of the secondary cat) of the professional association of ophthalmologists in Germany and the German Ophthalmological Society. V.
2. ↑ J. Gonnermann, S. Al-Mulsi, M. Klamann, A.-KB Maier, M. Pahlitzsch, N. Torun, E. Bertelmann: Long-term results and complications after surgical post -cataract suction . Clinical Monthly Ophthalmology 2016; 233 (08): 910-913, DOI: 10.1055 / s-0042-100002. Georg Thieme Publishing House
3. ↑ Springer Link - W. SchremsG. K. Krieglstein: Risks of post-start therapy with the neodymium-YAG laser. Contribution to the 1st congress of the German Society for Intraocular Lens Implantation pp 94-100

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