Posted , 9 users are following.
Hi, I'm still not sure whether to do an exchange or give up on it and proceed with YAG (positive dysphotopsia + pco). I'd like to ask you one thing. Since my dysphotopsia is being caused by the IOL itself (not by PCO), why many say that after YAG (I need it due to PCO) my sypthoms are going to be even worse? That's what I heard from a few ophthalmologists. All in all, t's going to restore my normal acuity.
1 like, 16 replies
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Sue.An2 ad12345
Posted
Hard to recommend one way or another on YAG. Have heard both ways - that it can make dysphotopsia worse and better.
I wound say thought that you should at least seek out 2nd opinion from reputable surgeon who specializes in exchanges their professional opinion on whether to exchange IOL. It is certainly advisable to exchange before doing a YAG vs afterwards.
brooketastic ad12345
Edited
I developed positive dysphotopsia after YAG, and after doing tons of research on dysphotopsias in general, the opinion I keep seeing is that, if you're unhappy with dysphotopsia, do not go for YAG. The YAG will most likely not help.
If the dysphotopsia is driving you crazy, I'd go for that exchange while you can. I'm stuck with my dysphotopsia after having YAG in both eyes. Most doctors seem to agree that the brain does not adapt well to the positive light streaking, unless it's fairly mild. If it aggravates you, I'd explore the possibility of lens exchange while you can. Certain types of lenses and lens materials seem more prone to these dysphotopsias than others.
I definitely agree with the other poster on seeking a second opinion. In my appointments, I found it useful to bring illustrations of the light streaking I was experiencing (doctors took me more seriously when they saw how large the lights were). Even hand drawn can help. If a surgeon downplays your experience, I definitely recommend finding another. Someone will be sympathetic to this, and will know how to help. Unfortunately some doctors see a perfect surgical result, and don't understand that our subjective experience is still very distressing.
For what it's worth, I really didn't notice any visual improvement after my YAG. I had some blurry halos around lights, which promptly turned to extreme light spikes after the membrane was removed. The dysphotopsia was much more impairing than the PCO itself.
ad12345 brooketastic
Posted
Did you develop Postivie Dysphotopsia before YAG or after it? Cause you said it appeared after YAG. What lens do you have?
brooketastic ad12345
Posted
I developed the positive dysphotopsia after the YAG. I also developed PCO immediately after surgery (within days) so the doctors believe it could have been there before, but the PCO obscured it. I did have some fuzzy halos around lights before the YAG, but not the streaks. I posted a picture of my streaks on another thread:
https://patient.info/forums/discuss/questions-about-2nd-yag-procedure-728169
I have Tecnis Eyehance toric set for distance in both eyes. My lenses are very high power.
I use pupil constricting drops at night for my dyspohotopsia now - they are basically a cure while they're effective, and I'm happy to have found a solution, but I would prefer not to need to use them at all.
soks brooketastic
Posted
i have fuzzy halos from the start. immediate PCO. now i am scared of YAG.
DMarie2020 brooketastic
Posted
Hello, which drops are you using. I have Brimodine which give little relief, but some. It basically turns some of the streaks to "flare". I only use it if I have to go out at night. You used the word "cure", so I'm wondering which one you are using. I found the first time I used it, it seems to work well, but no so much afterwards.
I have the Alcon Acrysoft IQ. My lens are also high power - 12.0 / 11.0
ad12345
Edited
I travelled to another country to see a reputable surgeon. He looked into my eye and said he can't tell whether the IOL is stuck or not and he will only know this once surgery has started. In the first scenario he is going to put another IOL into the bag, including polishing my PCO. If the iol is stuck, he will stop and remove lens with the bag altogether, using sclera or pupil fixated IOL. He said the decision whether to continue or not is entirely MINE. I believe he is a very talented surgeon, but in fact I feel alone with it. Making such a decision on my own looks like flipping a coin. What do you think? I'm 4 years post op, PCO, no YAG.
soks ad12345
Posted
who is the surgeon? is he in europe? i am 3 years in.
Guest ad12345
Edited
Bear in mind if the bag is lost and they have to affix the IOL with an alternative method I think that means they have to use a 3 piece IOL. So the choice of lens options goes down. I guess it depends on how bad the current situation is. If it's really bad and everyone is telling you that YAG won't fix it (or may even make it worse) I'd personally take the risk on the exchange.
ad12345 Guest
Posted
The problem is that alternative method requires about 6 mm incision, fixation of the new IOL with sutures and vitrectomy. Obviously my current situation is bad but am scared to death of ending up much worse...
ad12345 soks
Posted
Yes, in Europe. Aspira-aXA IOL.
ad12345 Guest
Posted
Bear in mind that I need YAG not to improve Positive Dysphotopsia, but to remove PCO which currently obscures my vision. These are two completely different things.
Guest ad12345
Posted
Is he able to give you any guess as to the chances that a simple 1 piece IOL will work for the exchange? I know they don't like to do that surgery much more than 6 months post-op but at 3 years is it like… 50/50 that the bag will be ok? Or 20/80? Or just no way at all to know?
ad12345 Guest
Posted
He says he will know that once the surgery has started.
maria52867 ad12345
Posted
Hi,
Who is the surgeon? And in which country?
It's almost five months since my surgery and I'm a bit desperate because time just flies, and my current surgeon doesn't really take it seriously and thinks we should wait and see. My lens sac was already small postop. because my eye is short due to high farsightedness (my IOL is +30).
I also have developed PCO.