Light fog/spilled light after the YAG Capsulotomy

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Yesterday I've undergo YAG Capsulotomy. My doctor said everything was fine and told me to come next week. it's in distant city.

Unfortunately a few hours later I left the clinic I've noticed that each light source (lamp, window, LCD) generates massive annoying light fog. I mean each light source look like observed through the fog or through the smoke. That also makes the overall contrast lower.

I've read about possible floaters but I had only one that currently is unnoticeable.

I've also find some info (unfortunately after the procedure, it seems you have to goggle really specific phrase) that very common is IOL pitting and I'm afraid that it can be my case...

Can it? I've seen some fog also after the cataract surgery, but it was LESS intensive...

I've read that lens pitting can cause massive glare... but I've also found some presentation in which pitting effect was illustrated rather as a small bright points around the light bulbs...

Can it be caused by too small hole? I've got a nystagmus and it is my only seeing eye so we started from the small hole. Unfortunately I've forgot to ask which pattern my doctor planned to use (round is safer because we do not shoot directly through the axis of vision). And yes, he used that special lense during the procedure (although I don't know the YAG offset - I've read about it today)

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13 Replies

  • Posted

    Hi Piotra,

    Here is some dated 2013 information from the AAO:

    Intraocular Lens Damage

    Pitting of IOLs occurs in 15% to 33% of eyes during Nd:YAG laser posterior capsulotomy. Pitting is usually not visually significant, although rarely the damage may cause sufficient glare and image degradation that the damaged IOL must be explanted.

    The type and extent of lens damage depend on the material used in the IOL. Glass IOLs may be fractured by the Nd:YAG laser. PMMA IOLs sustain cracks and central defects with radiating fractures. Molded PMMA IOLs are more easily damaged than higher-molecular-weight lathe-cut lenses. Damage to silicone lenses is characterized by blistered lesions and localized pits surrounded by multiple tiny pits. The damage threshold is lowest for silicone, intermediate for PMMA, and highest for acrylic materials.

    Frequency of damage depends on IOL style. IOLs designed with a ridge separating the posterior capsule from the IOL sustain less damage than lenses with a convex posterior surface and close apposition between the posterior chamber IOL and the posterior capsule.

    There is also a more recent 2021 article in Ophthalmology Research:

    Ophthalmic Res. 2021 Jun; 64(3): 417–431.

    Published online 2020 Nov 20. doi: 10.1159/000513203

    PMCID: PMC8259068

    PMID: 33221803

    Analysis of YAG Laser-Induced Damage in Intraocular Lenses: Characterization of Optical and Surface Properties of YAG Shots

    Andreas F. Borkenstein* and Eva-Maria Borkenstein

    Hope this helps!

    • Posted

      I know, I found all these things today, after my YAG. Before I was so ensured that is safe and easy... 😦 Now I found tons of info about pitting, different results for different holes shapes (round and cross) different floaters amount, risk of RD, different risk of IOL pitting (some say cross is still safer because of less shoots, some say it isn't because of higher power), different level of light scatter...

      Perhaps it's only an coernal edema? Can it be? Or high IOP?

    • Posted

      Agree. Searching the internet can be scary! Maybe make a call to the doctor who did the YAG? One time I was fearing a rotated toric, and it was just dry eye that needed more artificial tears.

      Best of luck!

  • Edited

    What YAG technique?

    • Edited

      Unfortunately didn't asked. I suppose crucial because of no floaters (and yes, that shape cause much bigger intraocular light scatter) - which is perhaps also less safe for the IOL although I found two different researches and in one of them (but on the tiny group) there were less pitting with cross shape used. In another article about light scatter levels they also had two groups and for crucial had been used smaller energies (sic! - safer for vitreus and retina) so I suppose a lot of things depends on operator.

      The only good thing is in some conditions my diplopia reduced because it's blurred now and I see clearer distant lights so perhaps some problematic points from my posterior bag were removed but for what price?...

    • Posted

      Typically the cruciate method is more likely to cause IOL damage, especially with silicone IOLs. The can opener round flap approach is less likely to cause IOL damage but is more likely to cause floaters, and having the flap created interfere with vision.

  • Posted

    Jesus now I can't see proper colours on any graphic - I thought after YAG I will see sharper and better... 😦 Everything is covered by light fog.

    • Posted

      From "Yag Laser Capsulotomy N2S

      "It is common to have floaters and/or a film over the eye after YAG capsulotomy. This results from the debris caused after laser treatment. This usually slowly resolves in a few days to few weeks after treatment."

      I don't know if your "fog" is the same as the "film" referenced above, but maybe it will clear after a few weeks. But definitely follow up with your provider. From the way you spell, I assume you're not in the USA.

  • Posted

    Sorry for my English never had gift to learn foreign languages. 😃

    it seems that capsulotomy was carried out very well and IOL is OK. So perhaps it's size of the capsular hole or some corneal problems...

  • Posted

    Your English is fine. From the way you spelled "colours" I thought you lived in the United Kingdom or Canada. If you have concerns, you need to follow up with your doctor, even if it is some distance away.

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