Are there risks in delaying YAG treatment for PCO?

[Ron_AKA]

I had cataract surgery nearly 3 years ago in my right eye. About 11 months after surgery I had a PVD event in this eye. I had cataract surgery in my left eye about a year and a half ago and got the PVD in this eye 13 months after surgery. I understand risk of PVD is quite elevated about a year after surgery, and my experience seems to validate that.

When I had a regular eye exam about 2 months ago I commented that having the PVD shadow in both eyes now was kind of like looking through a dirty windshield with two flies chasing each other around, the optometrist responded by saying I had PCO in my left eye which had the most recent surgery, and there was nothing in my other eye done about 3 years ago. Aside from the PVD shadows I can't see anything different in this left eye compared to the right. The optometrist suggested getting YAG done in the left eye. I have to admit I am skeptical about doing that as YAG seems to be over prescribed as a cure all. So I procrastinated by saying I would get the opinion of an ophthalmologist that is a laser specialist, and that I had a routine checkup scheduled for October of this year. The optometrist said he would do a referral to that specialist and that is my current plan.

So, my question is whether or not I am taking any extra risk in delaying the YAG assuming the laser specialist also believes it is necessary? Would there be any risk of the PCO progressing to make the YAG treatment less successful? I know that the YAG is not going to do anything for the PVD, and not really seeing the PCO impacting my vision is the reason I have thought that action is not urgent. If there is risk, I guess I could move up the appointment with the specialist to get the second opinion earlier.

[John C Hagan III, MD, FACS, FAAO]

The purpose of a Yag laser for PCO is to improve the vision and that the patient looking through the PCO is bothered by the quality of the vision. if you are satisfied with your vision, there is no need to go to the expense of a Yag cap or the risks of Yag cap (which are small). In rare cases a yag cap is done because the ophthalmologist needs to see better into the back of the eye for treatment such as laser for diabetic retinopathy.

[Ron_AKA]

Thank you for the advice. I will hold off on it until my exam in October and go from there.

[John C Hagan III, MD, FACS, FAAO]

Good plan

[Ron_AKA]

Had my appointment for the second opinion on the need for a YAG with a laser surgeon. It was a bit of bad news, but mostly good news. Unlike the  optometrist who only saw PCO in my left eye, the surgeon said I had some in both eyes, and if anything the right eye was a bit worse. That makes more sense as the right eye IOL has been in for about 3 years compared to the left eye at 18 months. In any case he said there was no hurry to do YAG on either one, and I am to go back in a year for a recheck.

[John C Hagan III, MD, FACS, FAAO]

Yes doing a yag is like cataracat surgery, you don't do it until your vision is a significant problem.