Advice needed after YAG laser capsulotomy went wrong.

I have no experience with YAG, so can only offer you some suggestions based on what you describe. Is the flare bands you are seeing only at night? Also is this a one eye effect or both? If it is night only, that would suggest, as you have thought, it may be an issue of the pupil opening up and the opening from the YAG coming into the line of vision. I think I might want to get a second opinion on that possibility. Eye drops to constrict the pupil may be another way of testing that theory. I have not heard of lens pitting as an adverse outcome of YAG. Retina detachment is a risk but it is very low.

Hi arnold. Sending much Blessings your way for recovery. I cant help with the medical part but I familiar with area. Dr Safran is about one hour away from NJ biggest airport Newark Liberty. The closest motel is four minutes away from his Office. Perhaps due to distance Dr Safran could do a video chat or phone chat with you and have your Dr fax him your information and then you might have some kind of plan which does wonders psychologically. Dr Safran might be able to recommend UK or European specialist closer to you. I hope this helps

Thank you so much, RonAKA and mary27273 for your veru speedy replies, and for trying to help me.

To answer your questions, RonAKA:

These bands are most troublesome at night, but I see them at other times. For instance, even if I look at a bright light in a brightly lit room I see them. I even see them coming fro the sun if it's partly obsured by a cloud.

And it's just in the YAGd eye: before I had that darned YAG, both my eyes were perfect.

I'm almost certain it's the laser pitiing that's the cause, but I'd love to be proved wrong, as a different cause might be easier to fix.

after yag safran might be the way to go for lens exchange. he is not too bothered by surgery done a decade ago. i havent had the exchange but i have seen him.

although do keep in mind that he has kind of move on attitude. this isnt serious so deal with it and move on with your life kind of thing.

he may also feel that instead of pitting capsule flaps might be still in your visual axis and may recommend making the YAG opening larger.

good luck.

Have you had a thorough exam of the eye, including a look at your retina? From what I've read, YAG treatment can cause some retinal issues.

I have no experience with a YAG but my understanding is that it is done when a cataract patient experiences pco not for glare issues.

I've seen other reports regarding YAG-induced lens pitting that you describe, and I think you're on the right track. For example, elsewhere on this forum, one patient described seeing halos in horizontal and vertical crosses after YAG, which turned out to be the exact pattern of his YAG procedure (YAG is also sometimes done in a circle). As you know, YAG blasts laser pulses behind an IOL to obliterate the rear portion of the capsular bag. The slightest mistake in measurement is a laser blast to your IOL.

It's unfortunate and frustrating that doctors have minimized these negative result and pushed you off into glasses that only mask the problem at best. And you shouldn't have to mess with pupil size to fix it. Your doctors are "very unhappy"? Well, too bad for them!

(1) Yes, I think it's reasonable to conclude the problem is lens pitting. You've done your homework correctly. Don't grind yourself down chasing illusory and wishful alternatives that are long shots at best.

(2) I'm unaware of any solution except getting a new IOL.

(3) My first-hand recommends for doctors are only in the U.S., but perhaps you can contact a top physician here and they can recommend someone who is top-quality and closer to you.

Don't despair. You'll feel better when you're firmly on a path to fixing the problem.

I want you to know that I'm having the EXACT problem. Beautiful vision until the YAG. Now I have these absolutely insane light spikes at particular angles.

Whether or not we have obsessive personalities, anyone in the world would be dismayed by MASSIVE spikes of light blasting across our field of vision like laser rays.

I was given the runaround by my surgeon after the YAG. They kept blaming dry eye, then glasses (I've had 3 prescriptions which did not help at all), and finally sent me to a cornea specialist. Anything to blame but themselves.

I've had several eye doctors look at my implants (not cataract surgeons, but other specialists) and none noted any signs of pitting. I thought I'd share this, because my problem sounds very similar to yours, but mine isn't caused by pits. I'm quite certain the YAG opening is too small. The surgeon would not consider this a possibility, even though I brought it up twice.

My thoughts? Before considering an exchange for the pitted lens, I'd see a new surgeon and ask about the YAG size. Of course, I'd ask them about the pits, as well.

I'm booked to see two new surgeons as of right now. Don't fall for the doctors brushing you off. I've photoshopped illustrations of my lines to show them - people tend to believe we're exaggerating, especially if we seem nervous or upset while we're trying to explain ourselves. You deserve to have your evenings back (as do I).

I wouldn't get the second eye done until you have an answer. I had both eyes YAG'd a week apart, and I absolutely wish I hadn't. I would reverse the decision in a heartbeat. I chaulked the lines in the first eye (my more troublesome eye) up to healing. The lines are WORSE in the second eye that was done. By a lot.

Are the streaks present when your eyes are perfectly still? Or do they only appear when you move your eyes? I have something similar after a YAG and the doctor could not see anything wrong with a slit lamp examination. In my case, it only happens when I move my eyes. It looks like a blurry line moving across my field of vision. When I told the doctor this, he had me move my eyes while under the slit lamp, and he could then see a piece of lens capsule being kicked up into my visual axis. Not sure if this is the cause in your case, but just thought I would mention it in case it helps you troubleshoot your problem.

One thing that is unfortunate is that a lot of opthalmologists don't care about things like this because they are only interested in eye pathologies. If there is no underlying eye problem, they trivialize any problem the patient may be having because in their view, the eye is perfectly fine. It is frustrating for the patient whose quality of life is being affected because the doctor seems unwilling to put in the effort to figure it out.

Best of luck Arnold. I hope you find a solution to your problem.

I too am going to enquire to Dr. Safran's office.