It was really exciting to be at the forefront of accreditation with the Specialist Optometrist Scope for Ophthalmic Laser Surgeries certification process, specifically to perform Nd:YAG laser capsulotomy and laser peripheral iridotomy. We are the first new optometrists registered since the initial pilot programme completed by Greenlane Clinical Centre-based optometrist Richard Johnson in 2023.
The Optometrists and Dispensing Opticians Board (ODOB) set detailed criteria for extensive learning prior to seeing patients, so a significant amount of our time was devoted to the study of YAG laser capsulotomy techniques, risks and potential adverse effects. An understanding of the physics, laser mechanics and machine parameters was also required, which we had not touched on since university days. We created a compendium of learning from the resources and discussions with ophthalmologists.
After completing our initial readings and theory requirements, we studied surgical videos of the capsulotomy process and techniques. We then progressed to performing mock capsulotomies using tissue with clear gel, bubble wrap with intraocular lenses (IOLs) inserted to simulate posterior capsular opacification (PCO). The simulations are valuable for initial skills and understanding, but these synthetic models have a number of limitations and are clearly (pun intended) unable to replicate the complexities of live YAG capsulotomies, especially in cases of dense PCO, retained cortex, IOL opacification and various IOL-capsular bag configurations.
Going live
Once we were in a position to start our supervised capsulotomies, one of the most challenging aspects was not the procedure but aligning schedules and locations for the patient, ophthalmologist and optometrist!








