Yag Capsulotomy

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Hi all.  

Recently been diagnosed with Posterior capsular opacification (Pco) 2 years after refractive lens exchange and have been scheduled to have a Yag laser capsulotomy.  My near vision in one eye gradually started to become a bit cloudy/misty and my optometrist said this was due to pco.  It wasn't until just now I was wondering is it normal for pco to only affect near vision?  My distance vision is totally unaffected and I'm wondering has anyone else on here had the same situation.  And if so, did the yag clear the near vision problem without compromising the distance vision?  The reason I'm concerned is that it has taken nearly 2 years for my distance vision to settle into a stable state and I would hate for it to go now!

 

Cheers all.

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8 Replies

  • Posted

    The PCO is like looking through a film. If the PCO were the main cause for the degradation of the near vision, then it would have affected your distance vision also. If your distance vision is fine, then the probable reason for a degradation in your near vision is that you have become slightly farsighted. The PCO is probably not a significant contributor to the degradation in the near vision.

    It is possible that you were slightly myopic earlier, which did not affect your distance vision much, but was helpful in getting a better near vision

    My suggestion will be to have your vision checked by another optometrist or opthamologist.

    The YAG capsulotomy is a relatively easy procedure, but there are some disadvantages too in having it done. So, you should get it done if you really need it, but that may not solve your near vision issue.

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    • Posted

      Hi At201

      Thank you for your helpful and informative reply. I do find it odd that the pco would not be affecting my distance vision so, like you suggested, I have arranged to see another optometrist next week. Cheers.

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    • Posted

      I too have to have the YAG capsulotomy in both eyes after my cataract surgeries of April 26 & May 2, 2017.  I got PCO right away in each eye. What are the disadvantages to having it done?  Thank you!

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    • Posted

      I am sorry to learn that you need to have YAG capsulotomy in both of your eyes to correct the PCO so soon after the cataract surgery.

      I don't mean to discourage you from having the YAG capsulotomy if the PCO is affecting your vision. The main message I was trying to convey to Brizy was that having it done is not without some disadvantages or concerns, even though those are small

      The first disadvantage is that you are making a hole in the posterior capsule. You are weakening the structure in that area, but it probably does not have any practical effect. You are also making it even harder to replace the IOL if needed (the opthamologists don't like to do it any way). This is because there is a chance that the lens being replaced falls through the capsule hole towards the back of the eye, while the opthamologist is trying to replace it.

      The other uncommom concerns are: potentially affecting the smooth spherical surface of the lens with laser, retinal detachment (may not happen for some time), macular edema, and increased eye pressure (of special concern to someone with pre-existing glaucoma).

      Best wishes for successful YAG capsulotomies in both eyes.

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    • Posted

      Thanks so much for your reply.  At this point I think this is the best option for me.  My near vision is pretty good, but my distance vision isn't good. God Bless You and Take Care!

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  • Posted

    Since you had RLE (rather than cataract surgery) I'm guessing the odds are you got a premium IOL, likely a multifocal and are using near vision via that rather than using reading glasses. Multifocals split light, and there is less light for the near focus than there is for distance, so any reduction in that light due to PCO might be more noticeable. Its also possible that your visual acuity, 20/X or 6/X or whatever, isn't as high at near and that any reduction in that is more noticeable when you are trying to make out letters. At distance usually we aren't focusing on fine detail and so reductions in visual acuity may be less obvious.

    Unfortunately the average time for PCO to set in is someting over 2 years. YAG can change the refraction, but I don't recall it as being a large impact. If it is, then laser correction is likely possible to tweak it back.

     

     

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    • Posted

      You are quite right softwaredev, I did have multifocal lenses fitted and don't use glasses at all.  What you say makes sense and encouraged me to look into the finer details of the lens.  Apparently, like you said, most of the light is dedicated to the distance portion of the lens with the rest split between the intermediate and near portions.   Have you had the yag capsulotomy? And if so, was it worth it?  I must say I do worry that there may be a change in refraction because, other than the recent cloudiness, my vision is pretty much 20/20 and N5 and i would hate to compromise that.

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    • Posted

      Fortunately most people now don't need YAGs with modern IOL designs  and surgical techniques  (it used to be that most did need them). So  perhaps if you do need a YAG in one eye, you'll be lucky and not need it in the other. 

      I fortunately haven't needed a YAG (and a surgeon said at my 2 month postop that he doubted I'd ever need one based on how it was healing, hopefuly he is right, at almost 2.5 years postop there is no sight I'll need it). My impression is they are usually worth it since otherwise the cloudiness gets worse. Its only perhaps like one or two percent who ever need it done more than once. It sounds like the vast majority have good results, its just not guaranteed 100%, but almost no surgery is. I haven't paid attention to the statistics though since I haven't needed one. 

      I can understand not wanting to risk the good results, but it seems likely that even if the were some slight reduction in visual quality in one eye, that between the two you likely wouldn't notice a difference.  You can always consider a laser touchup if it does alter the refraction. 

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