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Old 09-27-2005, 12:01 AM   #1
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post-cataract surgery YAG for posterior capsular opacification

I had cataract surgery a few months ago. My vision is now more obstructed by foggy glare than it was before the surgery. I probably have "posterior capsular opacification" because of the surgery and the nature of the types of lens implants I received.

Has anyone had the YAG laser procedure to poke a hole in the posterior capsule?
Was it very effective?
Was there any negative effect?

I am hesitant to have it done because once it is done it is much harder to replace the intraocular lens in the future.

 
Old 09-27-2005, 04:51 AM   #2
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Re: post-cataract surgery YAG for posterior capsular opacification

Posterior capsule opacity may be treated with an in-office or outpatient minor laser procedure known as a YAG laser capsulotomy. In this procedure, a laser is used to remove the hazy capsule situated behind the IOL implant. This usually requires dilation of the eye prior to the procedure. The procedure takes only a few minutes, is entirely painless, and is not associated with any post-operative discomfort. Most EyeMDs will recommend an anti-inflammatory eye drop medication following the procedure. Following a YAG laser capsulotomy procedure, patients may resume normal activities immediately. Most patients may expect their vision to improve within a day following the procedure. As with any eye procedure, patients should contact their EyeMD immediately if visual acuity worsens or fails to improve. Patients should anticipate some “floaters” following this procedure, however, these will likely resolve within a few weeks time.

 
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Old 09-27-2005, 05:55 AM   #3
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Re: post-cataract surgery YAG for posterior capsular opacification

Right. And thanks for reminding me about dilation (in my job this means I would NOT be able to resume normal activities immediately).

Does anyone out there have personal experience?

 
Old 09-28-2005, 04:25 PM   #4
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Re: post-cataract surgery YAG for posterior capsular opacification

Hi Serious Person
I haven't been on much lately. Wondered how you and In Hiding were doing.
I had the capsilotomy done about 15 years ago (Guessing on the time). They used the YAG. I walked in, they put in drops, did the laser and that was it!
I probably waited an hour, then popped my contacts back in and off I went!
Easiest thing ever!. The only thing I've gotten from it was something my dr called a "pearl", which as far as I can tell is a little part of the opening tries to regenerate and creates a little bump on the edge. It seems to come & go out of my line of vision, and am told that can be lasered off too. But it doesn't bother me enough to have that done. Other than that, I've had crystal clear vision since. 20/25, and that was after the capsilotomy, cataract & four retinal detachments, so I think it's a good procedure, with more benefits than anthing adverse. I can't drive at night, but with all my procedures not sure wich one caused all the starbursts around the lights. I don't think it was the capsilotomy though, but only guess that it could be from the surrounding fogging of the capsule. Not sure there...just guessing.
Let me know how you make out, if you decide to go ahead with it.
How's the vision therwise, after the two cataracts?
Hoping you are well
Hellas

 
Old 09-29-2005, 11:02 PM   #5
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Re: post-cataract surgery YAG for posterior capsular opacification

Hi Hellas
I was wondering about you and In Hiding too.
I'm still adjusting.
I just got reading glasses about a week ago.
And driving glasses a couple of weeks before that.
Both have improved my functional vision tremendously.

But the halo/starburst thingys at night keep growing by leaps and bounds.
I was thinking the YAG would take care of that.
But then I (mistakenly) thought the same about cataract surgery.
So if my daylight vision is clear, I'm guessing I'll postpone the YAG as long as is considered appropriate.

Thanks for the input!
Sounds like you're doing pretty well too.

 
Old 10-04-2005, 08:52 PM   #6
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Re: post-cataract surgery YAG for posterior capsular opacification

This is a common procedure generally w/o any pitfalls.It is virtually unheard of to have to replace an iol.

 
Old 10-04-2005, 09:52 PM   #7
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Re: post-cataract surgery YAG for posterior capsular opacification

kws6000, Your post is obviously intended to be nothing more than encouraging and to allay any fears and anxieties, and for that I thank you.
But my track record with medical procedures has been rather grim.
It's to the point where when I read something like, "generally w/o any pitfalls," I can only think, "Hmmm, 'generally,' well, that leaves me out."
There is some dry humor there if it doesn't crumble when exposed to examination.

The crystalens IOL is not working as it should, and the ReStor is just a dysfunctional design. As I am "only" 52, and IOL technology is growing rapidly, I would like to keep the window open for replacement IOLs that might at least let me see well with only one pair of glasses.

And, since I would be having the YAG because of poor night vision with giant halos and starbursts...well, that was why I had the cataract surgery, and now it's much worse.

And I'm now doing two peoples' jobs at work, where good vision would be really helpful, since I'm already dealing with a lack of access to the server, while my boss keeps giving me things to do on it. So, frustration and disillusionment are a bit high at the moment.

But the weather has been lovely.

Last edited by seriousperson; 10-04-2005 at 09:52 PM.

 
Old 10-05-2005, 06:45 PM   #8
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Re: post-cataract surgery YAG for posterior capsular opacification

Unfortunately secondary cataracts usually get worse so at some point your decision about getting the laser treatment may be made by default.
Your secondary cataract is likely affecting how well your iol is functioning although obviously your surgeon would be able to better assess this.
When you are more inclined to consider the yag procedure ,I would suggest that you ask your surgeon about the pros/cons and ask him point blank that if he were you , would he would get it done.

 
Old 10-05-2005, 07:40 PM   #9
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Re: post-cataract surgery YAG for posterior capsular opacification

Hi SeriousPerson,
I don't think the capsilotomy made the starburts/halos at night any better. Due to the lens capsule becoming cloudy, just like a cataract, is the most likely culprit. But the YAG procedure only puts a tiny hole in the central vision so the opaqueness in the surrounding lens capsule will still be present.(At least that's my understanding.) So if your day vision is ok and hasn't created serious vision deficiency than wait it out before you do it. I've gotten used to not driving at night. It's a pain in the neck when the days are so short in the Winter, but you adjust to it. You just have to do more planning ahead. But ask the dr about it, because if it will improve the night vision, then it may well be worth doing. At the very least the day vision will greatly improve. I've never regretted having it done for a minute. It was quick, easy & cleared my day vision dramatically.
Hellas

 
Old 10-07-2005, 07:09 PM   #10
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Re: post-cataract surgery YAG for posterior capsular opacification

I saw the doctor yesterday. I have an appointment in 3 months, at which time he thinks it might be time for a YAG. He also said that if my vision deteriorated a lot before then to call for an appointment. He showed me a plastic model of an eye with the posterior capsular opacification. It also had a post-Yag replacement part. The hole in it was maybe a third of the diameter of the capsule.
When I went for a second opinion before my second surgery, the ophthalmologist said the the halos would get better after the opacity matured and I had the YAG because a smaller circle of light would be allowed through to the retina, and the halo's from the crystalens (reflections off of the edge) would be screened out. Doesn't make sense to me, though, seems like it would just diffuse the light from the reflections into an overall glare.

 
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