In the majority of persons who underwent a cataract surgery, the posterior capsule is going to be subjected to a fibrosis process, because of which the capsule becomes clouded, interfering with the normal passage of the light causing a clouding of the vision very similar to that caused by the cataract. This condition takes the name of capsular fibrosis, but is more commonly known with the improper term of secondary cataract. It is good to keep in mind that the new clouding of the vision is not due to the opacification of the artificial lens implanted during the cataract surgery, in fact this remains perfectly transparent throughout the patient’s life, but to the posterior capsule on which the lens is positioned.
The visual impediment caused by the secondary cataract can be easily removed through a posterior capsulotomy with YAG laser, a fast and painless laser treatment that creates in the posterior capsule a small opening able to free the optic axis and restore a clear stable vision. After diagnosing the secondary cataract, it is a good thing not to wait too long before executing the posterior capsulotomy since, if the fibrotic process advances too much, then the incision of the capsule with laser could be difficult, giving origin to the need to use greater energy and determining the arising of possible complications during or after the laser treatment.
For the purpose of optimizing the security of the treatment a new YAG laser has been recently introduced, which issues a radiation in a fraction of billionth of a second, such a short internal as to make it almost impossible the arising of a possible “domino effect” with transmission of energy from the posterior capsule through the vitreal body to the retina, reducing almost to zero the risk of possible complications, in particular in diabetic patients (diabetic macular edema) or in those with macular pathologies (macular pucker, lamellar macular hole, cystoid macular edema, etc.).
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