WHAT IS A “POSTERIOR CAPSULOTOMY”?
Posterior capsulotomy is a surgical procedure which is sometimes necessary to clear vision after cataract surgery. The natural lens inside the eye focuses light rays. This lens has a thin outer “skin” called the capsule. Normally, the lens is clear. When it becomes cloudy and interferes with vision, it is called a cataract and the only treatment available is to remove it.

WHAT DOES THE CAPSULE HAVE TO DO WITH CATARACT SURGERY?
There are several ways to perform cataract surgery. One of the most frequent methods is to remove the cloudy portion of the lens, leaving the back capsule intact. This technique maintains the normal barrier between the front and back portions of the eye. It also serves as a “pocket” or “bag” into which an intraocular lens implant can be placed.

WHY IS A POSTERIOR CAPSULOTOMY NECESSARY?
The posterior capsule is normally clear. With time, this capsule can itself become cloudy or wrinkled. It acts much like a piece of cellophane which is easy to see through when stretched tight, but harder to see through when wrinkled. A surgical opening in the capsule can easily be made to again restore normal sight.

This opening can be done using a needle or with laser surgery. It is not necessary to remove the capsule. An opening in the center will allow clear, uninterrupted passage of light. The laser procedure requires very close and precise focusing by the ophthalmologist. The patient usually experiences no pain. The procedure usually lasts only a few minutes.

While the technique of posterior capsulotomy is usually effective, as with any surgical procedure, rare complications can occur such as hemorrhage, and loss of vision.

WHEN SHOULD A CAPSULOTOMY BE PERFORMED?
Follow up is important even after your eye has healed from cataract surgery. A capsulotomy may be recommended if your vision is decreased from the clouding of the capsule.

Many people may eventually need a capsulotomy after cataract surgery, especially younger people. The need for a capsulotomy should not cause undue concern, since the clouding or wrinkling is part of the body’s normal healing process in a certain percentage of patients.