Pain after YAG laser for posterior capsule

[mlouie]

Last March I had YAG laser surgery to correct posterior capsule opacification following cataract surgery. The surgery went fine and I used NSAID drops for 10 days, since I had problems tolerating steroid drops after cataract surgery (they gave me severe, systemic side effects). Immediately after the surgery, I developed a headache as well as pain in the orbital bones around the eye. The eye itself was pain free and pressure was normal. I saw a retina specialist the next day (due to increased floaters, which turned out to be existing floaters that I couldn't see before with a cloudy capsule). I am highly myopic so it made sense to see the retina specialist anyway. My retinas looked great and eye pressure was fine. I saw an eye doctor a week later due to the pain in the orbital bones and she said everything looked normal, eye pressure was fine, and there was just a little bit of inflammation that she thought was normal. I saw the surgeon 6 weeks later and everything looked great, eye pressure was good. But it took a full 6 weeks after surgery for the pain in the orbital bones to subside (it gradually diminished over the weeks). I now need the YAG laser on the other eye because it's become so blurry I can't see to read or drive with that eye. I'm worried about having pain again after surgery. Any idea what caused the pain? I did not have an abnormal level of inflammation in my eye after surgery or any increase in pressure, so that doesn't explain it. And the eye itself was pain-free. It's also possible I'll need to repeat the YAG laser in the first eye since the vision is deteriorating and getting a little blurry again.

[JohnHaganMD]

Your problem is extremely rare.  The lens capsule that is cut does not have nerves or blood vessels so there are no pain receptors. Inflammation is ultra rare. We do not use any drops on our patients and we do thousands of yag capsulotomies every year (we have 15 ophthalmologists). To do a yag typically takes me about 1 to 2 minutes. I have no idea why your orbital bones would have been painful. Since your problem was as rare as unicorns I can't tell you anything about the other eye except its highly unlikely.  As for your first eye ask the eye MD as it is also rare to need a yag a second time

[eyepain_278]

After yag surgery 6 months ago I still have severe pain in my orbital bones.  I have seen various Doctors and they all see "no problem".  So why is there so much pain 6 months later?  This isn't "rare as unicorns".

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

Your pain is due to something besides the yag capsulotomy. Given the way the energy of the yag is not radiated into the eye there are no credible reports of persistent pain due to the yag treatment itself, the first post not excepting.