A laser is a high-tech device that produces very high-energy light beams that can cut tissues in certain types of surgery. Most cataracts are removed surgically by a method called extra-capsular cataract extraction. In this procedure the front part of the capsule – the membrane enclosing the cataract – is opened and the cloudy lens is removed; the back part of the capsule is left in place to support a plastic intraocular lens (IOL). Many months or even years after the surgery that capsule remnant and some remaining lens cells may become cloudy and cause blurry or poor vision. It may seem to you as if the cataract has returned.
The cloudy remnant is called posterior capsular fibrosis. If you develop capsular fibrosis—about half of cataract patients do – that becomes so opaque that you have trouble seeing through it your vision can be made clear again with a procedure called a laser capsulotomy. This quick and painless surgery involves using a laser to cut an opening in the posterior membrane. Nothing has to be removed as it did with the original cataract surgery.
YAG Laser and Capsulotomy
A laser is a high-tech device that produces very high-energy light beams that can cut tissues in certain types of surgery. It has significant advantages over a scalpel. Not only can it make more precise cuts it can make them inside the eye without needing an incision through the outside of the eye. There is almost no risk of an ocular infection and no problems related to wound healing.
A YAG laser is used to painlessly cut a small opening in the capsule remnant. Amazingly it can cut behind the IOL without damaging the IOL. It is not necessary to remove the entire capsule but only to make an opening in the center to allow the clear passage of light rays. Enough of the posterior capsule is left to hold the IOL in place.
How Is the Surgery Performed?
Laser capsulotomy is an outpatient procedure. It does not require hospitalization or general anesthesia. You will be comfortably seated in front of the laser instrument. The surface of your eye will be numbed with anesthetic eyedrops. A special contact lens will be placed on your eye to help in focusing the laser beam. It also will prevent you from blinking during the procedure. As you look at a target the doctor will look through a slit lamp (clinical microscope) to direct the laser beam at the area being treated. Each time the laser is “fired” you will see a flash of colored light and hear a quick tapping sound. After the surgery you should begin to see well within a few hours. Your eye doctor may check your eye pressure later that day or the next. He or she may also give you eyedrops or an ointment. Once the posterior capsule has been opened it won t cause your vision to cloud again.
Laser ni kifaa cha hali ya juu ambacho hutokeza miale ya mwanga yenye nguvu nyingi sana ambayo inaweza kukata tishu katika aina fulani za upasuaji. Matatizo mengi ya jicho huondolewa kwa upasuaji kwa njia iitwayo extraction ya jicho la jicho lisilo na kifungo. Katika utaratibu huu sehemu ya mbele ya capsule <unk> utando kufunika cataract <unk> ni kufunguliwa na lensi cloudy ni kuondolewa; sehemu ya nyuma ya capsule ni kushoto katika nafasi ya kusaidia plastiki intraocular lens (IOL). Miezi mingi au hata miaka kadhaa baada ya upasuaji, mabaki ya kiwambo na baadhi ya chembe za kioo zilizobaki zinaweza kuwa na mawingu na kusababisha maono yasiyo wazi au mabaya. Huenda ikaonekana kwako kana kwamba ugonjwa wa kiwiko umerudi. Mabaki hayo yenye mawingu huitwa fibrosis ya nyuma ya kifuko. Ugonjwa wa capsulary fibrosis (kapsular fibrosis) unaoweza kuathiri uwezo wa kuona kwa urahisi, unaweza kufanywa wazi tena kwa utaratibu unaoitwa capsulotomy ya laser. Upasuaji huu wa haraka na usio na maumivu huhusisha kutumia laser kukata ufunguo katika utando wa nyuma. Hakuna kitu kinachopaswa kuondolewa kama ilivyokuwa na upasuaji wa awali wa cataract. Laser ya YAG ni kifaa cha teknolojia ya juu ambacho hutokeza miale ya mwanga yenye nishati ya juu sana ambayo inaweza kukata tishu katika aina fulani za upasuaji. Ina faida kubwa kuliko kisu cha kukata ngozi. Hii haimaanishi kwamba inaweza kupasua kwa usahihi zaidi, lakini pia inaweza kupasua ndani ya jicho bila kupasua nje ya jicho. Kuna karibu hakuna hatari ya maambukizo ya jicho na hakuna matatizo yanayohusiana na uponyaji wa jeraha. Laser ya YAG hutumiwa kukata kwa urahisi ufunguo mdogo katika mabaki ya capsule. Kwa kushangaza, inaweza kukata nyuma ya IOL bila kuharibu IOL. Haipaswi kuondolewa kabisa, lakini tu kufungua sehemu ya kati ya kifuniko ili kuruhusu mwangaza wa mwanga. Sehemu ya kutosha ya kifuko cha nyuma imebaki ili kushikilia IOL mahali pake. Upasuaji huo hufanywaje? Upasuaji wa capsulotomy ya laser ni utaratibu wa wagonjwa wa nje. Haihitaji kulazwa hospitalini au anesthesia ya jumla. Utakuwa umeketi kwa urahisi mbele ya kifaa cha laser. Sehemu ya juu ya jicho lako itazimwa kwa matone ya macho yenye kutuliza. Lens maalum ya mawasiliano itawekwa kwenye jicho lako ili kusaidia katika kukazia mwangaza wa laser. Pia itakuzuia usipige macho wakati wa utaratibu huo. Kwa mfano, daktari anaweza kutumia darubini ya kliniki (microscope) kuelekeza mwangaza wa laser kwenye eneo linalotibiwa. Kila mara laser inapofyatiwa <unk> utaona mwangaza wa nuru yenye rangi na kusikia sauti ya kupiga haraka. Baada ya upasuaji unapaswa kuanza kuona vizuri ndani ya saa chache. Daktari wako wa macho anaweza kupima shinikizo la jicho lako baadaye siku hiyo au siku inayofuata. Huenda pia akakupa matone ya macho au mafuta ya kutibu. Mara baada ya capsule ya nyuma imefunguliwa haitasababisha maono yako kuwa na mawingu tena.