To dangerous to do a yag laser treatment?

[madcatwoman]

I had a rezoom lens implanted in my left eye and tecnis multifocal lens in my right eye in March. I am 35 year old female. Apart from less than perfect intermediate vision I am very happy with the lenses and am adapting well to them. Unfortunately I've had PVDs in both eyes so the swirly floaters are annoying at the moment. I also have lattice degeneration and was quite myopic (around -8).

My tecnis multifocal eye has already developed pco - covering about a third of the capsule. I went for a yag laser proccedure and was all set up in front of the machine. The surgeon was struggling and suddenly left the room to get more advice. She came back and told me they had decided it was too dangerous to do the yag. To come back in 6 months and they could see if they could do it then. After some pressing she said that there usually is a slight gap between the capsule and the lens but my capsule was tight against the lens and she was worried that she might damage the lens.

My question is - how common is this. Is it likely that if the pco progresses I will be able to have the yag proceedure? There is already noticable haziness in my vision. Does having a multifocal like the tecnis with many rings make it harder to focus the laser?

Many thanks.

[Eye-Kant-C]

A related discussion, Laser Scuffs? after YAG - Crystalens was started.

[barby33]

A related discussion, eye floaters was started.

[madcatwoman]

Thankyou. It looks like I need to talk to my cataract surgeon after he gets back from his holidays and ask why the other surgeon felt it wasn't safe to go ahead. It doesn't seem to add up.

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

A Yag laser capsulotomy is not a difficult procedure to do and multifocal implants don't make it harder than normal.  The problems of a yag laser capsulotomy in a multifocal patient are: 1. After a yag capsulotomy a lens exchange or replacement is much more difficult and complication prone. 2. In an accommodating or true focusing implant opening the capsular bag may affect the ability of the implant to change shape in a manner that the eye may not focus as well because the capsular bag is not as tense. 3. while lens "laser marks" may theoretically be more of a problem than monofocal lens the patients in my practice don't seem to notice the laser scuffs on the implant at all.

So the biggest issues are items 1 and 2.

JCH III MD