Please share PCO/YAG experience

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?

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.

Can you help 're my reply to socks above please. Beryl - Unlike you all I am going with NHS and aren't able to get to talk to them except for unfrequent appointments.

hi w-h, i didnt read this message earlier. but i wondered the sane thing about capsule sticking to the iol and also about the vitreous gel hitting the iol. my mom says that after yag a piece of capsule would stick to the iol and would go away on its own. she says they did another yag which cause retina to detach. dont know if this was a floater or a capsule flap.

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.

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?

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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...

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When he checked the eye he said it is not as bad as he had thought. Very light.

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Far/RE's capsule on the other hand was crystal clear on next day post OP check.

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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.

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.

I wonder whether surgeons at initial consult actually let their patients know what type of cataract they have. I never knew. Makes me curious to see my file. thinking back all he mentioned was eczema treatments (was having a bad flare up at the time noticeable on my hand) accelerate cataracts. Mine did affect vision quickly from one year's regular optometrist appt to the next.

my optometrist did when i asked him why the hell do i have a cataract at 41? surgeons did not but it was on their report. the report said i have both posterior sub capsular and nuclear age related cataracts. now that is just fantastic! my optometrist appointment was march 30. everything was fine and dandy. i didn't let him dilate as i never had him ever before. july i was diagnosed with left eye vision badly impacted.

derek same as you. optho sees beginning of PCO but i notice nothing. How long can we wait to do YAG?

i had peripheral pco at 5 weeks. mild pco at 7 weeks. vision was not impacted at the time. Around 17th day the light halos started to show a flow. vision was gradually impacted with near going first followed by intermediate. at around 10 months nightime green stop light got distorted. earlier i could clear the blurriness by blinking. now i cannot. i can see the pco if i see at light with barely open eyes. it looks like circular cells. u can wait until it bothers you. yag can scratch the iol. some doctors do yag again to blast floaters. yag has retina detachment risk for younger males.