1. How long after the surgery did you get diagnosed with PCO and when did you get the YAG? 2. What were your symptoms of PCO? 3. Did YAG clear the PCO symptoms or did nothing to improve vision? 4. Was any special method for YAG used such as the cruciate method? 5. Did you have non YAG posterior capsulotomy instead? 6. For those with multifocal lenses did near vision not improve after YAG? 7. What are the post YAG complications you faced? (floater, glare etc.) 8. Did you address these complications? (vitrectomy, etc) 9. If do you not have PCO and not had YAG and are still reading this and have had surgery more than 3 years ago then how long has it been since the surgery.
The only thing I can answer is...
- YAG can change your refractive readings. Very slightly or none would be the ideal outcome.
I got hit with PCO within 8 weeks of the op in right eye where the car. It took a while to settle in. After 1+ year; reading was stable - 20/20 but go have quite a bit of scarring and PCO. Not doing any YAG for now; i got hit with another detachment on the other eye. Surgeon told me to hold as it is not urgent as vision is fairly ok- can drive.
RE Lens Exchange and vitrectomy on 9/19. YAG on 10/18 due to fold(s) causing Maddox rod effect. Maddox rod effect resolved but started seeing multiple light streaks. Dr believed it was catching the edge of the capsulotomy. Larger hole on 10/30. Improved but not perfect. Still see some streaks but they are tolerable. Visual acuity didn't change after first YAG. I have not had my vision tested, but feel like it changed slightly for the worse after second YAG. What is the cruciate method and non YAG method? Floaters were minor and have mostly resolved.
Seems like you posted a while back about the doctor you would have do your YAG. Would you mind sharing again?
i have only spoken with kugler and safran about YAG. safran said he would make a large hole. did you visit him again to increase the size of the posterior capsular opening? i am undecided but may go to Wills eye's dr. Blecher. if you are in florida you can try Basscom Palmer hospital. cruciate method is where they make a cross in the middle and let the capsular flaps float backwards. non YAG method is surgical intervention for posterior capsular opening. done prior to YAG days or for children at surgery immediatly following iol implantation. was your visual acuity impacted by PCO for it to improve?
- How long after the surgery did you get diagnosed with PCO and when did you get the YAG? -- 5 weeks. no YAG yet.
- What were your symptoms of PCO? -- halos around lights got weird flow in it. concentric circles got smudged. without the smudge the circles are very pretty. near acuity impacted around 3-4 months. i could see 3 large cell like structures in the innermost ring against glasses reflection or through barely open eyes against light. around 10 months a right side tail for lights. stop light expecially green one became scattered dots. note cataract also affected the green light the most. distance acuity getting affected. earlier i could blink to make it clear. now it no longer gets clear.
- Did YAG clear the PCO symptoms or did nothing to improve vision? -- worried it wont and then exchange will no longer be an option
One thing i don't understand...so capsule is shrink wrapped to the IOL by the time you go for YAG. You hit the capsule through the IOL and make the X pattern. What if the flap of the capsule stays glued to the IOL? What the hell then? Will they keep hitting it? Won't that start damaging the IOL? Do IOL manufacturers even test their IOL to see if they are YAG proof?
Thx. I saw Safran both times. It's interesting/unfortunate that we not only have to worry about the edge of the IOL but also the edge of the capsulotomy! Yes he did increase the size of the opening. I only had trace PCO in this eye (RE) so I can't really answer questions about PCO. My YAG was for Maddox rod effect. I want to get my vision tested to see if/how it changed after the second YAG. It seems like either astigmatism increased and/or I am more myopic. I noticed this change as soon as the dilation drops wore off.
Soks,
Sorry to jump on your thread, but I am going in for Lasik on the eye with my Restor 2.5D IOL in a few weeks. This is to adjust the outcome from my original surgery (~ 20 months past) by +0.75D. I wear contacts periodically to make this adjustment and it has helped improve my vision in the ~10ft range without sacrificing my distance, so I think this is a good option. It's also free instead of ~$3,000 USD because adjustments were included with the multifocal IOL.
However, at the same appointment where we made this decision, the doctor mentioned my PCO and said he'd schedule YAG a month or two later to remove it. My quandary is that although I know that he can see the PCO, I don't actually notice anything negative in my vision that would lead me to request YAG at this time. On this board, I have heard of some negative results so I'm leaning towards delaying this surgery until I notice something negative in my vision.
I would not have a YAG if you don't have any symptoms. There is a grading scale for PCO from 0-4. Did dr by chance tell you what yours was? I didn't notice anything in my right eye with grade 1. My LE with grade 2 is noticeable.
i agree. vision is very gradually affected by PCO. unless it is impacting. no need to yag.
How long after the surgery did you get diagnosed with PCO and when did you get the YAG?
over a year, got yag a year later, grade 2
What were your symptoms of PCO?
blurry near vision, need more light too compensate, just like a cataract
Did YAG clear the PCO symptoms or did nothing to improve vision?
restored near vision
Was any special method for YAG used such as the cruciate method?
yes
Did you have non YAG posterior capsulotomy instead?
no
For those with multifocal lenses did near vision not improve after YAG?
yes
What are the post YAG complications you faced? (floater, glare etc.)
floaters weren't an issue but glare seemed to increase for some reason--you think it would be the opposite but apparently removing that thin membrane can have an effect on how the light is seen by the retina so it can in theory mask issues that become apparent post yag as well as improve things too.
Did you address these complications? (vitrectomy, etc)
no, not much they can do. However, it seemed that my doctor used significantly more pulses and higher energy than another doctor i asked so not sure if that caused problems or not or if it was just how much was needed to vaporize the tissue. Procedure is easy but i keep thinking when is he going to be done
If do you not have PCO and not had YAG and are still reading this and have had surgery more than 3 years ago then how long has it been since the surgery.
- How long after the surgery did you get diagnosed with PCO and when did you get the YAG? 1 year
- What were your symptoms of PCO? Slight hazy/foggy vision in daylight
- Did YAG clear the PCO symptoms or did nothing to improve vision? Day vision clear
- Was any special method for YAG used such as the cruciate method? Yes cruiciate method used.
- For those with multifocal lenses did near vision not improve after YAG? Near vision remains good
- What are the post YAG complications you faced? (floater, glare etc.) Now I see along with severe starbursts on lights (which has been there since surgery) flairs of lights (following the x pattern) extending out way past the regular starbursts.
- Did you address these complications? (vitrectomy, etc) Surgeon suggested pilocarpine, no other YAG procedure as capsule is open.
The question I do have is did the YAG damage the IOL, if not why do I see these extended starburst flairs in the x pattern? I have not been able to ask that question yet. I see him again the begining of December. All in all, not happy I had YAG done.
He was kind of nonchalant about it. He noticed some "tissue" and wanted to do the YAG to get rid of it. No grading. I am going to hold off on this until it affects my vision. I'm sure I'll need it eventually but unless waiting makes the procedure more difficult, I don't see the reason to do it now.
Won't people who had fast spreading cataract also have fast spreading PCO? .
The surgeon cleaned my wife's LE capsule the best possible without risking a capsule tear. Next day after the OP the surgeon said accidentally that my wife had polar cataract so let us see how dirty the capsule is 1 day post OP, but on checking the files he started saying Posterior Subcapsular Cataract. It got me confused and scared for the right eye which had not been operated at that point as polar cataract has higher capsule tear chance... . When he checked the eye he said it is not as bad as he had thought. Very light. . Far/RE's capsule on the other hand was crystal clear on next day post OP check. . Btw is polar cataract completely different form Posterior Subcapsular Cataract or is it just a subset of it?
To my question-
Posterior polar cataracts are characterized by well-demarcated white opacities in the center of the posterior capsule. These opacities often project forward as cylinders penetrating into the posterior lens cortex. Etiology
Posterior polar cataracts are typically congenital and autosomal dominantly inherited. Symptoms
Most posterior polar cataracts are asymptomatic or minimally symptomatic. However, over time posterior subcapsular (PSC) opacities may form around the posterior polar opacity. As the PSC progresses, vision may be severely affected.
Posterior polar cataracts pose a unique challenge for cataract surgery. The rate of posterior capsular rupture is significantly higher in these cases. The posterior capsule is weakened around the posterior polar opacity and in some cases there may even be a defect in the capsule.
you are correct. posterior sub-capsular cataracts is type of cataract more prone to early PCO. and the damn thing starts in the center of the visual axis.
you bring up interesting points W-H. posterior polar cataract is completely different from posterior sub capsular cataracts. i kept repeatedly asking that question to every surgeon i met as i was super freaked about polar cataracts. polar cataracts are also congenital in most cases. the lens just compensates for its presence until they interfere when presbyopia kicks in and the lens can no longer compensate. polar cataracts are also usually accompanied by a weak capsule hence the risk of tear.
Komiko, sorry to hear you are not happy with the YAG X starbursts. I hope the clearer vision is at least a relief.
Do you have a multifocal or a monofocal IOL? One, or both?
I know virtually nothing about YAG but it might help to know if the X pattern you see is in the same axis as the laser cuts your surgeon made. If it is, perhaps it's from the cuts? The first thing I just read mentions pitting in the IOL from the laser, which with the cruciate method is in the center of the visual field. I truly don't know, just raising the question. Will be interested in hearing what your surgeon says in December.
Derek, just know that Lasik can cause starbursts and other visual aberrations, and most folks I know who got lasik, while basically content that they did it (of course...they have to accept it in the end), they are still wearing glasses. One says her whole family got lasik and they all need eye re-wetting drops now all the time.
If it were me I'd stick with contact lenses if they work. Minimal inconvenience.