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Definition
Due to the use of a YAG (yttrium-aluminum-garnet) laser to do surgery hence the term so.
One use for a YAG laser in surgery is to punch a hole in the iris to relieve increased pressure within the eye from acute angle-closure glaucoma. In this type of glaucoma, there is a sudden (acute) increase in pressure in the anterior (front) chamber of the eye due to abrupt blockage of the normal circulation of fluid within the eye.
There are other kinds of YAG laser surgery for the eye (e.g., for cataracts) and other areas of the body including the skin (e.g., to remove birth marks).
YAG laser surgery is an office procedure. It is also used in some hospital procedures including laparoscopy for endometriosis.
Steps Of Yag Laser Surgery
YAG LASER produces a concentrated beam of light that can focus on the iris or any thick membrane behind the intraocular lens.
This laser beam can create a smooth ,fine opening of desired size in these structures without affecting other sensitive parts of the eye.
YAG LASER treatment is done as an Out Patient procedure. Special eye drops are put in the eyes to numb them . A small contact lens is placed on the eye to direct the laser light on to the desired site.
The treatment takes only few minutes and the patient can go back home immediately.
Laser surgery is safe and painless with few complications.
Applications where YAG LASER is used
Posterior Capsulotomy
Treatment of secondary cataract. This accounts for 95% of the YAG therapy modalities. After cataract surgery with the implantation of a posterior chamber lens (IOL) clouding of the remaining posterior lens capsule can occur in some cases. This can cause a considerable impairment of vision (“secondary cataract”), and a posterior capsulotomy is required. This treatment consists of opening the centre of the posterior lens capsule with the aid of a YAG laser.
Cleaning Of Iol Surfaces
Clusters of cells are sometimes deposited on the surface of implanted intraocular lenses, making the lens cloudy or opaque. The YAG laser is used with very low energy to remove these deposits from the surface of the IOL. This would appear to occur primarily with the now increasingly used silicone lenses.
Anterior Capsulotomy
This application, is performed in preparation for capsulorhexis (opening of the anterior capsule wall) as part of cataract surgery.
Iridectomy/ Iridotomy
Treatment for lowering intraocular pressure when flow of aqueous humour between the lens and the iris is blocked. A hole is created in the iris with the YAG laser. This treatment is performed when there is an obstruction in the flow of aqueous humour between the crystalline lens and the iris (angle-closure glaucoma and chronic glaucoma with a narrow chamber angle); the aim of the treatment is to reduce the intraocular pressure (IOP) or to prevent the same condition in the partner eye in the case of acute glaucoma (condition where the pressure of the eye is raised that causes pain and loss of vision.YAG LASER is used to create a small openning in the Iris to facilitate the flow of liquid outside the eye.without surgical intervention) .
Trabeculotomy/Goniotomy
Treatment of glaucoma. An opening is created with the YAG laser in the tissues responsible for the the outflow of aqueous humour, in cases of obstruction or blockage. Trabeculotomy is rarely performed with the YAG laser. A generalised form of trabeculotomy is goniotomy. Here, the fluid outflow chamber angle is deepened with the aid of the YAG laser. Indications for goniotomy include primary congenital glaucoma found mainly in infants, and juvenile glaucoma as a special form of open-angle glaucoma.
Removal Of Synechiae
Synechiae is an adhesion of the iris to surrounding tissue. The YAG laser can treat anterior (adhesion around the cornea) and posterior (adhesion to the lens) synechiae. Anterior synechiae can, for instance, occur after corneal transplants, starting from the edges of the wound. Posterior synechiae can occur in angle-closure glaucoma.
Severing Vitreous Strands And Membranes
Treatment in which vitreous strands and membranes are severed with the help of a YAG laser. This is done in order to avoid the risk of traction on the retina which could lead to retinal detachment. This is only performed by experienced retinal consultants.
After Cataract or Posterior Capsular 0pacity
A membrane is left behind in Cataract surgery. This membrane supports the IOL { Intra Ocular Lens or Artificial lens} inside the eye.It may get thickenned or opaque as a process of scarring few months following surgery.This may reduce the vision again even after good and successful cataract operation. YAG LASER is used to clean this opaque membrane.
