YAG capsulotomy required six weeks after cataract surgery
Posted , 5 users are following.
Hi there,
I'm a 51yo British male with high myopia (around -7.5/-8.00) diagnosed for cataracts after experiencing worsening vision problems over the past year or so (glare, double vision, difficulties reading, frequent changes of prescription).
I had my first surgery, on my right eye, two days ago (Thursday). At the end of the procedure the surgeon said everything had gone fine. However, he then said that because of the specific type of cataract, the lens capsule itself was also cloudy and that this would require YAG laser capsulotomy. He said this would be scheduled for six weeks from now to allow the eye to satisfactorily heal and settle down first. At the time I didn't think too much about it, but afterwards I wished I'd asked him for a more detailed explanation of this phenomenon and its potential effects.
Having done a bit of research, I'm fairly sure the type of cataract I had/have is a posterior subcapsular cataract; it just ticks all the boxes. What I haven't been able to find is any explanation as to why having this particular type of cataract might be associated with capsular clouding requiring immediate YAG capsulotomy.
I'm now 48 hours post-surgery and my operated eye is still unusable. It perhaps feels slightly less photosensitive today than it did yesterday, but everything is so cloudy/hazy that it's like I'm peering through a sea of fog. (I should mention, secondarily, that I'm also seeing some quite large floaters in the operated eye.) At the moment I'm having to cover up the right lens of my glasses and just rely on the unoperated/uncorrected eye. I realise that for some people it can be a few days after surgery before the initial blurriness goes away, but given what the surgeon said about needing YAG capsulotomy, I'm a bit worried that this extreme cloudiness may be caused by the clouding of the capsule rather than simply normal post-operative effects. And if that's the case, I'll be stuck with it until I have the YAG capsulotomy, which basically means I'll be reduced to using only one eye for the next six weeks, which will be a nightmare.
So, in summary, I have two questions:
Can anyone shed any light on why having posterior subcapsular cataracts might be associated with concurrent clouding of the lens capsule requiring YAG capsulotomy as soon as possible after cataract surgery? Any links to relevant information would be appreciated.
Is the sort of extreme cloudiness of vision I'm currently experiencing a normal part of the post-operative healing process?
Many thanks in advance.
0 likes, 20 replies
RonAKA robg_uk
Edited
If you google this article you may find it of interest.
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Healio August 08, 2018 BLOG: When opacification is not caused by PCO
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A quote:
"An interesting variant on this theme of PCO developing late after surgery are cases where it seemingly appears the day after surgery. How can it be possible that we are getting lens epithelial migration and proliferation this soon after surgery? The answer, of course, is that we aren’t seeing PCO in the traditional sense, rather we are looking at residual cataract that is stuck on the capsule. During surgery, after the lens material is removed from the capsule, certain cataracts – posterior subcapsular and posterior polar in particular – can leave behind a residual plaque on the posterior capsule. At this point, the surgeon will be faced with the option of attempting to polish this residual opacity off the capsule...."
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You can read through it, but it appears the standard treatment is to wait a few months and then do the YAG.
robg_uk RonAKA
Posted
Very interesting, thanks. In fact, in continuing to look into this over the past couple of days, I'd come to the conclusion that there was probably some residual plaque left on the posterior capsule.
RonAKA robg_uk
Posted
YAG is simply cutting a hole in the capsule to let the light through. What I am not sure about is where the cut portion of the capsule goes, and in your case the attached residual plaque. Is there a risk of this material becoming floaters? Not sure. Perhaps something to ask the surgeon about.
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About 10 months after my first cataract surgery I had a PVD (posterior vitreous detachment) event which has left a significant floater. It is not significantly impairing my vision, but is a bit annoying. I am not sure if those who have had YAG experience anything like this. I have not heard about it though.
robg_uk RonAKA
Posted
Yesterday I watched a YouTube video of a YAG laser capsulotomy in which the surgeon said the residual material remains in the eye but does not usually result in significant floaters. He said this was because the material is in the front of the eye, whereas floaters are usually in the vitreous, which is in the rear chamber, much further back in the eye.
FWIW, I'm very familiar with PVD: I've had one in my right eye (the one that's just been operated) for the past 18 months or so. Like you, I find the resulting floater mildly annoying but not significantly vision-impairing.