Post-cataract YAG laser treatment: Secondary cataract surgery
- Immediate & permanent removal of secondary cataracts
- Cost coverage by the health insurance company
- State-of-the-art treatment with YAG laser Artificial lens cloudy
What is an after cataract?
An after cataract, also known as a secondary cataract, is a clouding of the posterior lens capsule that can develop after cataract surgery. During cataract surgery, the cloudy lens is removed and replaced with an artificial intraocular lens. However, the lens capsule that held the natural lens remains in the eye to support the new lens. Over time, cells on this capsule can multiply and lead to clouding, which impairs the patient’s vision again – similar to an original cataract. A secondary cataract is not a new cataract, but a common and easily treatable complication after surgery.
Causes of secondary cataracts – How do secondary cataracts develop?
Remaining lens epithelial cells
After removal of the cloudy lens, some lens epithelial cells may remain on the posterior lens capsule. These cells can multiply and cause opacification.
Proliferation and migration of cells
The remaining lens epithelial cells can multiply and migrate along the posterior lens capsule, leading to the formation of a cloudy layer of cells. This layer of cells can scatter the light and impair visual acuity.
Fibrosis of the lens capsule
The lens capsule can thicken and harden over time (fibrosis). This change can impair the transparency of the capsule and lead to renewed opacification.
Inflammatory reactions
Mild inflammatory reactions may occur after cataract surgery, which increase the risk of cell proliferation on the lens capsule.
Properties of the intraocular lens (IOL)
Modern lenses – like the ones we use at EyeLaser – are often designed to minimize the risk of cell migration and proliferation.
Recognize the after cataract: Symptoms
A secondary cataract can develop after cataract surgery, although the length of time before it occurs can vary. A secondary cataract often occurs several months to years after the original operation. However, it is possible that it may not become noticeable for several years.
Symptoms of posterior capsule opacification
The symptoms of an after cataract are similar to those of the original cataract and can significantly impair vision. The most common symptoms include
Blurred vision
Patients often notice a gradual deterioration in visual acuity, similar to cataracts.
Increased sensitivity to glare
Light sources can be perceived as particularly glaring, which can be particularly annoying when driving or in brightly lit environments.
Veil vision
A feeling as if a veil or fog is clouding your vision.
Double vision
In some cases, double vision may occur, especially if the other eye is not affected.
Color fading
Colors appear less vivid and rich in contrast, which impairs color perception.
Post-cataract diagnosis at EyeLaser Vienna & Linz
A post-cataract diagnosis at EyeLaser in Vienna and Linz is based on a thorough ophthalmological examination carried out by experienced specialists.
1. anamnesis
- Discussion with the patient
- The ophthalmologist begins with a detailed consultation to understand the symptoms the patient is experiencing. Questions are asked about the visual problems, their onset and progression and about previous eye operations, particularly cataract surgery.
2. visual acuity test (eye test)
- Determination of visual acuity
- An eye test is performed to check the patient’s visual acuity. This helps to determine the extent of the visual impairment and to obtain an initial indication of a possible secondary cataract.
3. slit lamp examination
- Examination of the eye structures
- With the help of a slit lamp, a special microscope, the ophthalmologist examines the anterior and posterior eye structures. The slit lamp enables a detailed examination of the posterior lens capsule, where the secondary cataract may occur. This involves looking for opacities or cell deposits.
4. ophthalmoscopy
- Assessment of the inside of the eye
- An ophthalmoscope is used to examine the inside of the eye, including the retina and optic nerve. This helps to rule out other possible causes of visual impairment and to comprehensively assess the condition of the eye.
5. measurement of intraocular pressure
- Tonometry test
- The intraocular pressure is measured to ensure that there are no signs of increased pressure that could lead to further complications. This is particularly important as YAG laser treatment can affect intraocular pressure.
6. documentation and consulting
- Results and treatment plan
- Once the examinations have been completed, the ophthalmologist discusses the results with the patient. If a secondary cataract is diagnosed, the doctor explains the findings and recommends the appropriate treatment, usually YAG laser treatment. The treatment procedure, benefits and possible risks are explained in detail.
Non-binding preliminary examination: Have a diagnosis & treatment plan drawn up
If you suspect that you are suffering from secondary cataracts after your cataract surgery, we cordially invite you to visit us at the Eye Laser Center Vienna (or Linz). During our non-binding preliminary examination, we will carry out a holistic diagnosis and find the optimal treatment option.
YAG laser treatment: getting rid of cataracts / clouding permanently
The YAG laser, also known as the yttrium-aluminum-garnet laser, is a high-precision instrument used in ophthalmology to treat post-cataracts.
The YAG laser generates short, intense light pulses in the infrared range, which have a high energy. This energy is generated and amplified by a special crystal material, the yttrium aluminum garnet crystal. The resulting laser light is extremely focused and enables very precise treatment that is gentle on the surrounding tissue.
Clear vision in 3 steps: YAG capsulotomy
Preparation
Before the day of treatment arrives, you will have already been fully informed about the procedure, benefits, risks and side effects. Immediately before the treatment, you will be given eye drops to dilate the pupils so that you can see the posterior lens capsule better. Anesthesia is not necessary. The procedure is painless.
YAG laser
As soon as the drops have taken effect, you take a seat in front of the laser device and place your chin on a special support to keep your head stable during the procedure.
The ophthalmologist then places a special contact lens on your eye, which optimally directs the laser beams and enables precise focusing on the cloudy posterior lens capsule. The doctor can determine the exact position of the opacity through the eyepiece of the laser device. The cloudy capsule is cut through with short, controlled pulses of light from the YAG laser. The laser works with high precision and vaporizes the affected cells without damaging the surrounding tissue.
The targeted removal of the cloudy cells creates a clear opening in the posterior lens capsule, which allows light to pass through the eye unhindered and reach the retina. This leads to a significant improvement in visual acuity and eliminates the symptoms of cataracts.
The actual laser application only takes a few minutes. You will only hear a slight clicking sound and occasionally a brief flash of light when the laser pulse is emitted.
Aftercare:
1. direct aftercare immediately after treatment
- Checking the eye
- The ophthalmologist will examine your eye immediately after treatment to ensure that the cataract has been completely removed and that no immediate complications have occurred.
- Application of eye drops
- You will be given anti-inflammatory eye drops to help reduce any inflammation and support the healing process. These drops must be used according to the ophthalmologist’s instructions.
2. recovery at home
- Avoidance of efforts
- You should avoid straining your eyes immediately after treatment. This includes minimizing heavy physical exertion and strenuous visual tasks, such as reading for long periods or working at a computer.
- Eye protection
- It is recommended that you wear sunglasses for the first few days after treatment to protect your eyes from strong light and UV rays.
3. follow-up appointments and check-ups
- First inspection date
- A follow-up appointment is usually scheduled within the first week after treatment. At this appointment, the ophthalmologist checks the healing process and measures the intraocular pressure to ensure that it is within the normal range.
- Further follow-up examinations
- Depending on the individual healing process, further follow-up appointments may be necessary. These appointments are important to monitor the long-term success of the treatment and to ensure that no further complications occur.
4. signs of complications
- Observe symptoms
- Severe pain in the eye
- Sudden deterioration in vision
- Persistent redness or swelling of the eye
- Flashes of light or dark shadows in the field of vision
- It is important that you look out for any unusual symptoms and report them to your eye doctor immediately. Symptoms to look out for include:
- Immediate medical consultation
- If you notice any of these symptoms, see your ophthalmologist immediately so that possible complications can be treated at an early stage.
Beat cataracts a “second time” now:
Arrange your non-binding preliminary examination at EyeLaser Vienna or Linz now. Regardless of whether you have already had cataract surgery at our laser eye center or at another laser eye clinic. We will find the right solution for your cataract and give you a clear view of the finer things in life again!
Don’t worry: the costs for the treatment of cataracts are usually fully covered by health insurance.
Alternative treatment options for secondary cataracts
The YAG laser is the best way to remove the secondary cataract. Only in rare cases, in which the cataract is so severe that the YAG laser cannot be used, is a second surgical procedure considered. This is similar to the original cataract operation. The secondary cataract is removed manually.
If the secondary cataract is (still) so mild that you do not consider treatment with the laser to be necessary, the use of eye drops or glasses or contact lenses may be an option to alleviate the symptoms or delay a worsening.
There are currently no other options for removing the after-cataract after cataract surgery.
Why the YAG laser is the best solution:
Minimally invasive procedure:
No incision is required and the patient does not need anesthesia. Rapid recovery with little post-operative discomfort.
High precision:
The YAG laser enables precise and targeted treatment. The risk of damage to surrounding tissue is minimal.
Lasting results:
The secondary cataract is permanently cured by the YAG laser. The risk of it occurring again is extremely low. And even then it can be treated again.
Costs covered by insurance:
As a rule, treatment is covered by statutory and private health insurance companies in Austria. There are no or only low out-of-pocket costs.
High success rate:
The success rate with the YAG laser is over 95 percent. Almost all patients experience a significant improvement in vision after treatment.
Short treatment duration:
The procedure only takes a few minutes per eye. Immediately afterwards, vision is clear again and the cloudiness has disappeared.
Quick recovery:
Patients can usually return to their daily routine on the same day. Side effects rarely occur and are usually temporary.
Painless procedure:
Treatment with the laser does not cause any pain. Not even a local anesthetic is necessary. No pain is to be expected after the procedure either.
After cataract treatment costs: What the health insurance covers
The treatment of a secondary cataract that occurs after cataract surgery is generally covered by health insurance in Austria. This is because cataract removal is a necessary medical measure to restore the patient’s vision.
Statutory health insurance funds:
- Assumption of costs
- Reason: Post-cataract treatment with the YAG laser is an established and necessary medical intervention to correct complications after cataract surgery.
- Procedure: Patients do not usually need to obtain prior authorization. The costs are covered directly by the health insurance company, provided the treatment is carried out by a licensed ophthalmologist.
- Exceptions and co-payments
- Possible co-payments: In some cases, small co-payments may apply for special examinations or comfort services that are not absolutely medically necessary.
Private health insurance:
- Assumption of costs
- Reason: Private health insurance companies generally cover the costs of YAG laser treatment as it is a medically necessary measure.
- Procedure: Patients should check their insurance policy and, if necessary, obtain confirmation of coverage to ensure that the specific services are covered.
- Additional services
- Extended cover: Private insurance often offers a wider range of benefits and may include additional services such as special follow-up examinations or higher standards of patient care.
If in doubt, you should always contact your health insurance company in advance and clarify whether the costs will be covered. This will help you avoid unexpected out-of-pocket costs. EyeLaser will also be happy to guide you through the approval process and provide the necessary documentation for the health insurance company to cover the costs.
Risks, complications and side effects at a glance:
The treatment of after-stars with the YAG laser is considered safe and effective, but as with any medical procedure, there are potential risks and side effects. The most common side effects include temporary visual disturbances such as flashes of light or streaks, which can occur shortly after treatment. These symptoms usually subside within a few days. In rare cases, there may be an increase in intraocular pressure, which is why regular checks by an ophthalmologist are important.
Common side effects:
- Temporary visual disturbances (flashes of light, streaks)
- Cause: The treatment may cause temporary irritation of the retina.
- Measure: Rest and protect the eyes, avoid strenuous visual tasks immediately after treatment.
- Slight increase in intraocular pressure
- Cause: Laser treatment can lead to a temporary increase in pressure in the eye.
- Measure: Regular monitoring of intraocular pressure by the ophthalmologist; in some cases pressure-reducing eye drops can be prescribed.
Rare complications:
- Retinal tear
- Cause: In rare cases, the laser energy can damage the retina.
- Measure: Immediate medical treatment, often using laser therapy, to seal the tear and prevent retinal detachment.
- Retinal detachment
- Cause: A retinal tear that remains untreated can lead to retinal detachment.
- Measure: Emergency surgical treatment required to restore the retina to its original position and preserve vision.
- Inflammation or infection of the eye
- Cause: Bacterial or other microbiological contamination can lead to infections.
- Measure: Use antibiotic eye drops or other anti-inflammatory medication; adhere to strict hygiene guidelines.
During your preliminary examination, including an informative discussion, our ophthalmologists at EyeLaser will talk to you in detail about the possible complications of cataract treatment. So that you can decide on the procedure with a good feeling!
Your laser eye surgery specialists at the Eye Laser Center Austria
Austria’s most popular Femto-Lasik surgeons Dr. Victor Derhartunian FEBO & Dr. Paul Jirak FEBO in Vienna & Linz
Ophthalmologist, specialist in refractive surgery
FEBO
Having learned his craft from the two pioneers of laser surgery, Dr. Victor Derhartunian is one of the leading laser eye surgeons. He runs the practice in Vienna and can advise his patients in five languages.
Ophthalmologist, specialist in refractive surgery
FEBO
Dr. Paul Jirak ist Mitbegründer eines der renommiertesten Zentren für Augenlaserchirurgie in Österreich und behandelt seit 2014 Patienten in Linz. Er ist spezialisiert auf Augenheilkunde, Optometrie, Augenchirurgie und Augenlasern.
Ophthalmologist, specialist in artificial lenses and cataracts
FEBO
Dr. Leydolt is an ophthalmologist and specializes in cataract and lens surgery. She heads a research group with this focus, trains young surgeons and gives international lectures.
Questions and answers (FAQ) on secondary cataracts
After cataract surgery, secondary opacification of the lens capsule can occur. Here you can find out everything you need to know about secondary cataracts: how they develop, when they occur and how they can be treated quickly and painlessly with the YAG laser.
What is a laser treatment to remove the after-cataract
Laser treatment to remove the after-cataract is a painless procedure in which the clouding of the posterior capsule of the lens is removed using a laser. The laser is coupled to a slit lamp in order to be able to work precisely. During the procedure, a contact lens is placed on the surface of the eye and the pupil is dilated with eye drops in order to better reach the capsular bag. The entire process only takes a few minutes and is usually performed under local anesthesia.
How does a secondary cataract develop?
A secondary cataract occurs when lens epithelial cells remain and multiply in the capsular bag after cataract surgery following artificial lens implantation. These cells lead to a clouding of the posterior lens capsule, which impairs vision. The clouding of the lens capsule can lead to symptoms such as spots or thread-like opacities in the field of vision and sensitivity to glare.
What are the symptoms of a secondary cataract?
The symptoms of an after cataract include a deterioration in vision, spots or thread-like opacities in the visual field, and increased sensitivity to glare. Patients find these opacities very disturbing and often report a new haze that impairs their vision. These symptoms often occur months after cataract surgery and are an indication that a secondary cataract has developed.
What is a secondary cataract and how does it develop?
A secondary cataract occurs in around 20 percent of patients after cataract surgery and is a complication. The posterior lens capsule becomes so cloudy that vision deteriorates again. The clouding often occurs months or years after the original operation. The cause is that the cells on the lens capsule enlarge, blocking the incidence of light.
Why does a secondary cataract occur after cataract surgery?
In rare cases, it only lasts a few weeks. In most cases, however, cataracts appear within a few months. In some cases, it can even take years before it becomes noticeable. The first symptoms that should alert you are: gradual deterioration in vision, glare, especially in poor light and loss of contrast. However, the good news is that cataracts are usually easy to treat.
How is a secondary cataract treated?
The most effective and most common treatment for cataracts is with a so-called YAG laser. The cloudy lens capsule is precisely opened with the laser and the light can then fall unhindered onto the retina again, so that the restrictions are gone. The procedure is minimally invasive, painless and usually only takes a few minutes.
Is post-cataract treatment painful and safe?
No, in most cases patients do not experience any pain at all. The eye is anaesthetized with eye drops before YAG laser treatment. All you feel or see is a small flash of light and you’re done.
The treatment of secondary cataracts is extremely safe and complications are rare. Nevertheless, comprehensive information is provided about the possible risks and side effects of cataracts and the preliminary examination ensures that the procedure is tailored to the individual.
Can a secondary cataract occur again?
Theoretically, yes. However, this is very rare in practice. In most cases, secondary cataracts do not occur at all. If it does, it is almost always resolved with a single YAG laser treatment. Only in the rarest of exceptional cases does it return later. But then a YAG laser capsulotomy can simply be performed again. Regular follow-up checks ensure that the secondary cataract can be detected and treated in good time before you even notice it.
Laser eye surgery at the Linz Eye Center: What our patients say
Our laser eye surgeons Dr. Victor Derhartunian FEBO & Dr. Paul Jirak FEBO will recommend the right treatment for laser eye surgery in Vienna & Linz during your examination!