Any Experience /Knowledge with PVD after having a Cruciate YAG?

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I had cataract surgery in March on both eyes. Two weeks later I developed PCO and had YAG on both eyes 2 months later because I was having a lot of problems with my vision. I have also had positive dysphotopsia in both eyes (flickering in the bottom outside corners) from the day after both surgeries. Three days ago I started experiencing flashing in my left eye and just assumed it was the positive dysphotopsia. However, I got the flashing when I was in a dark room and even when I went to bed and closed my eyes I could still see the flashing, not something that happened with the flickering. Today I had a round shaped floater in my left eye and then a few dot shaped floaters. I was fairly positive it was PVD, but called my eye surgeon's office and got in to see a retinal specialist today. I have over Stage 3 PVD in my left eye which has detached from the retina and macula and Stage 2 PVD in my right eye which has not yet detached completely. Apparently the circle floater I have is very common and is called a Weiss ring. It is very annoying because it is in the center of my vision and moves with my eye and causes my vision to be hazy at times.

I am wondering if anyone has experience or knowledge about how a cruciate YAG "handles" PVD. In my left eye it looks like the flap on the outside of the YAG is floating in and out of my vision, but I am wondering if this is perhaps just part of the PVD I am seeing. Or as the vitreous is getting thinner I am wondering if it is unable to hold the YAG flap back any longer. I was not seeing this when I saw the specialist today, so didn't ask him.

Thanks for any information you can give me.

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9 Replies

  • Edited

    I have a PVD in both eyes now, and I agree, it can be quite annoying. Keep in mind that the PVD occurs at the back of the eye near the retina. It is the lining that contains the vitreous that is pulling away which the eye reports as a flashing light, although there is no light involved. The YAG procedure cuts a hole in the capsule that holds the lens and now your IOL, and is at the front of the eye. There should be no interaction between the YAG procedure and the PVD. It is possible that you are seeing the flap from the YAG however. Pretty much have to go based on what the ophthalmologist says is the issue. All I can say is that I have seen nothing that says PVD can be cured with YAG.

    • Posted

      I was thinking because the vitreous is getting thinner perhaps it wasn't thick enough to hold the flaps from the YAG down anymore. Until yesterday I couldn't see the flaps from the YAG at all, but perhaps it is not the YAG flaps I am seeing, but just floaters. Something I will have to ask the specialist when I see him in 4 weeks. He did say if the Weiss ring is bothersome it can be lasered. I have read that it can disappear in 3 months, so I guess it is a wait and see thing. It is very annoying because it is in the middle of my vision.

    • Posted

      My first PVD "blob" is still hanging in there after nearly 3 years. Second one is a year and a half.

  • Edited

    Hi. I am yet to have cataract surgery but do have PVD in both eyes.

    The first floaters appeared after a (very minor) injury to my eye. On examination I was reassured that the retina was ok but told that it would likely happen to my other eye before long. Sure enough 3 months later the same thing happened in the other eye, with no injury or other apparent trigger. (the second eye is actually worse)

    You don't state your age but this is pretty common in the over 50s (I was 54), and occurs less often in younger people too. Weiss rings are formed by a circle of material that tears from the area around where the optic nerve joins the retina at the back of the eye so it would seem unlikely to have been caused by the YAG which would target the front of the eye. It could be that this was going to happen anyway and that your procedures just triggered it.

    • Posted

      Did your floaters eventually go away? This Weiss ring is very annoying as it has landed in the center of my vision. Things I have read says it should eventually go away after about 3 months, but the retinal specialist said it is mine for life. I am 67 and I agree it was the cataract surgery that triggered it.

    • Edited

      A few have disappeared, but I'm left with a Weiss ring in my right eye and some cobwebs which I don't notice too much and a smaller ring and a big grey blob in the other eye. I notice the grey blob most and it is annoying when it drifts into my line of vision. I can move it by rotating my eyes though.

      They do fade, and they move, sometimes settling outside of the visual area, and your brain learns to filter them out to some extent but for me at least they haven't disappeared.

      There is a procedure to remove them but it shouldn't be taken lightly

      https://www.asrs.org/patients/retinal-diseases/28/vitrectomy-for-floaters

    • Posted

      I have read about that, and would really have to give it a lot of serious thought before having it done. I have read about laser Vitreolysis and will have to do more research on it, but it might be an option and something my retinal specialist had mentioned to me. I have a Weiss ring and another blob right beside it that are constantly in my vision and I find it hard to read or just in general to look at anything. My vision also gets hazy in that eye like my cataract is back, but then it clears again so I am assuming it must be another floater. My right eye hasn't finished the process of the vitreous detachment, so not sure what I will end up with in that eye. Still too early to make any decisions. I will wait a few months and see if they are tolerable to live with.

      Have you looked into laser vitreolysis?

    • Edited

      Yes I've researched laser vitreolysis. I found that there are many more opthalmologists who don't like it than do and not many will perform it. I won't consider it because of the potential for damage to the retina. Also I understand that in many cases the outcome is to break up rather than eliminate the floaters which means that you might just have lots of little ones instead of one big one.

      There is a treatment in development which uses nanoparticles (of gold I believe) injected into the eye which bind to the floaters and make focusing the laser on them much more accurate, meaning less potential for misses and that a much lower powered laser can be used, but I think that is a few years away from approval.

      That said I understand that the procedure is best suited to dense dark floaters like Weiss rings. I would give it some time and see how you do with them. For me it's been 14 months since they appeared in my right eye and 11 months for the left and I estimate that those in my right eye are now 75% less noticeable than at first and perhaps 50% in my left.

      Some people also say that taking supplements can help but most doctors take the view that since there is no blood supply to the vitreous that it's unlikely but I have been taking 1000mg of bromelain (a fruit enzyme from Pineapple) and 100 mg of papain (similar enzyme from papaya) for perhaps 8 or 9 months and have had some improvement. Whether that improvement would have occured without the supplements I have no way of knowing but the pills are cheap and there's no side effects (for me at least) so what's to lose?

    • Posted

      I have read the same thing, sometimes if the energy of the laser isn't high enough the floaters just break up into smaller floaters instead of being vaporized into gas. More floaters is not what I need. Too early to make that type of decision and I would really have to discuss it with my retinal specialist to see how he does it.

      I have heard about bromelain and will have to try it. I also heard using eye drops with hyaluronate in it is supposed to work, although there have been no studies to prove this. My drops for dry eyes has that in it, so I will see if that helps. Thanks for the info.

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