YAG Capsulotomy Safe and Effective for Patients with Uveitis

While YAG capsulotomy is generally considered a safe and effective treatment for PCO, the risk may be higher in subjects with a history of uveitis. The study authors suggested a three-month period of quiescence prior to the procedure to minimize the risk of uveitic flare. Photo: Nate Lighthizer, OD. Click image to enlarge. Despite the higher rate of posterior capsular opacification (PCO) in patients with uveitis, there is limited information on whether there are any additional risks or considerations for patients with a background of uveitis. Researchers from the University of Auckland in New Zealand aimed to determine the outcomes of YAG capsulotomy following cataract surgery in eyes with uveitis, including rates of complications, utility of pretreatment with steroid drops and predictors of visual outcomes. They found that PCO is a common complication following cataract surgery in subjects with uveitis, occurring in over one-third of patients within five years. Complications of YAG capsulotomy occurred in 15.8%, with increased frequency in younger subjects and in those within three months of uveitis quiescence. Reassuringly, 94.8% of patients achieved full resolution of inflammation within four to eight weeks of treatment.In 4,430 patients with uveitis, cataract surgery was performed in 596 patients (13.5%, 746 eyes). PCO developed in 250 eyes with a median time to PCO of 77 months and with a follow-up period of a median of 2.1 years. The median age at the time of surgery was 60.3 years, and 53.7% of patients were women. PCO developed in 17.3% by one year, 24.2% by two years, and 33.8% by five years.A total of 120 eyes of 101 patients underwent YAG capsulotomy during the follow-up period; 68.3% were women. The median age of the patients at the time of the procedure was 54.2 years. The anatomical classification of uveitis in 120 eyes was anterior (n=53), intermediate (n=17), pan (n=46) and posterior (n=4). Complications occurred in 19 patients (15.8%) and included uveitis flare (15.0%), cystoid macular edema (3.3%) and retinal detachment (0.8%). Of the patients who developed a uveitic flare, all were treated with topical steroids, and one individual required oral prednisone. This study found a statistically significant trend between younger age of the patient and higher risk of flare. Of the 15.8% of patients who experienced any complication, 98% reached a full resolution with appropriate treatment.“Adequate follow-up should be arranged by the treating clinician team within two weeks of a YAG capsulotomy laser treatment to ensure potential complications are assessed and appropriately treated,” the study authors wrote in their paper, which was published in Journal of Cataract & Refractive Surgery.The authors recommended a three-month period of quiescence prior to the procedure to minimize the risk of uveitic flare.Click here for the journal source. Ng HW, Al-Ani HH, Mpe D, et al. Rate of posterior capsular opacification and complications of YAG capsulotomy in patients with uveitis. J Cataract Refract Surg. February 25, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.