The Yag laser is used in ophthalmology to open the posterior capsule of the lens in cataract operations.

The Yag Laser is a laser emitted by Nd:Yag, with a wavelength of 1064 nm (neodymium), is a crystal used in solid state lasers (as opposed to others contained in gas chambers), which causes tissue rupture by delivering a short, high-power pulse.

Initially used in ophthalmology to open the posterior capsule of the lens (YAG capsulotomy) in cataract surgery, because in some cases, after a few months or years, the posterior capsule of the lens becomes opacified and vision becomes blurred. The posterior capsule is the only structure of the lens that is maintained during cataract surgery as it is used to house the intraocular lens that replaces the opacified lens. As the lens is much thinner than the natural lens, the capsule tends to retract and sometimes creates areas of scarring. This causes a loss of transparency with a low acuity similar to the initial one. The YAG laser easily resolves the situation, in a simple, painless procedure carried out in the consultation room. Clear vision is immediately restored.

Later, it was also used in glaucoma closed angle glaucoma (YAG iridotomy).

The Yag laser iridotomy is a quick and painless procedure which consists of making a small hole in the periphery of the iris using a laser. The procedure is indicated as prophylactic treatment in situations where the irido-corneal angle is narrow in order to avoid acute glaucoma This is caused by the closure of the angle by the iris root, causing pupillary blockage (the aqueous humour is prevented from draining and accumulates, thus increasing the ocular pressure). In other situations, the blockage may be caused by an anterior or posterior chamber phakic lens or as a result of iris adhesions to the posterior surface of the cornea (anterior syncytia) or to the anterior capsule of the lens after very severe inflammatory situations, as is the case with uveitis.

The iridotomy can open a passage, a bypass, for the aqueous humour, solving the blockage between the anterior chamber (the space between the cornea and the iris) and the posterior chamber (the place behind the iris where the ciliary processes, responsible for the production of aqueous humour, are located), balancing the ocular pressure.

The Yag Laser is an outpatient treatment, performed in a short period of time (15 minutes). It may be necessary to use pupil dilation drops. The anaesthetic used is topical.

Yag Laser treatment is a very safe technique, however there are some risks associated with it.

One of the most frequent complications is the occurrence of small injuries to the cornea if the laser shot is badly calculated. These lesions are transient and usually disappear without leaving any after-effects.

In the case of YAG laser capsulotomy, an increase in intraocular pressure may occur in the first few hours. This may occur as a result of obstruction of the trabecular meshwork by tissue particles and inflammatory cells that are detached after the procedure. In this case, the ophthalmologist will control the pressure and indicate hypotensive eye drops to reduce the intraocular pressure for a short period of time.

Less frequent complications may occur, the appearance of marks or cracks in the intraocular lens that may be damaged, which occurs very rarely, when the intraocular lens is located in close proximity to the posterior capsule and in cases of thick capsular opacification, which makes it difficult to focus the laser.

Although rare, among other possible risks and complications, we can highlight uveitis, cystoid macular oedema, corneal oedema and retinal detachment.

After the Yag Laser, the patient can resume normal activities. In the first few hours after treatment, the patient may report decreased visual acuity, or cloudy vision, but this is considered normal and disappears spontaneously.

The patient should not feel pain in the operated eye, so if there is any, please contact your ophthalmologist.

The treatment after the Yag Laser varies according to the individual experience of the ophthalmologist and should be prescribed by him. The use of topical anti-inflammatory drugs for one week is often useful to relieve possible discomfort and possible inflammation.

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