Last updated: 02/17/2009

Prior to performing a posterior capsulotomy, the doctor will perform a thorough ophthalmic examination and review any systemic medical problems. The ophthalmologic includes evaluation of visual acuity, slit-lamp biomicroscope examination of the eye...

to assess the extent and type of opacification and rule out inflammation or swelling in the front of the eye, measurement of intraocular pressure, and a thorough evaluation of the fundus or back of the eye to check for retinal detachments and macular problems, which would limit the extent to which the YAG capsulotomy could improve vision. A potential acuity meter (PAM) may be used to ascertain best expected visual acuity after YAG capsulotomy, and brightness acuity testing will determine the extent of glare experienced by the patient. Contrast sensitivity testing is employed by some doctors.

This procedure cannot be performed in the presence of certain preexisting ophthalmologic conditions. For example, irregularities of the cornea would interfere with the ability of the doctor to see the posterior capsule. Also, a laser capsulotomy could not be performed if there is ongoing inflammation in the eye, or if swelling of the macula (a part of the retina) is present. A laser capsulotomy would be contraindicated with glass IOLs. If macular edema is suspected, which can occur in up to 30% of patients who have undergone cataract surgery, a test called a fluoroscein angiography may also be performed.