Vision Problems Post YAG Capulsotomy

[NorthernLite]

I had a YAG Capsulotmy done on my right eye 6mos. ago and immediately following the laser I was confronted with a series of symptoms that have compromised my vision and some are still present.  Initially, I immediately had intense glare especially from overhead fluorescent lighting and huge starbursts when out in the sun.  This has subsided a little, but I still have a problem with overhead lighting, esp. flourescent and a small degree of sunbursts or glare and starbursting around lampposts.  Sometimes, that eye has a sensation of looking through a glass lens that has oil spread over it.  This is sometimes generalized and sometimes confined to the inner aspect of that eye, where I have noticed the most problematic.

From the beginning, the innermost aspect of my eye has a  hazy, cloudy patch that produces alot of glare and flickers when I move my eye left to right . This has been a constant since I had the laser, with little improvement.  Sometimes I notice a cloudy patch on other areas of my vision which clears after several blinks.  This is very annoying with the feeling that the vision in that eye is "impeded".  I also have experienced a lot of shadowing across my eye which is only now gradually improving and not so frequent.  

Three mos. post laser I had a lot of dark cobwebbing  and  large floaters suddenly appear in my vision.  This has subsided somewhat, but I still have the intense glare,glassy appearance in sunlight or under overhead lighting and a constant is the cloudy patch in the innermost aspect of my eye which flickers when I move my vision across it.  

  A visit to a fill-in Opthalomologist resulted in no answer and no evidence of a tear or retinal problem. Could you shed some light on what the problem may be? I am going to book another visit with my regular Opthalmologist which will take awhile.

[Michael J Kutryb, MD]

Here are some possibilities:  The yag treatment could have cleared the cloudy posterior capsule but also left a lot of capular remnant debris in the vitreous directly in your line of vision.  It is also possible that you developed some new substantial floaters after the yag laser treatment.  Perhaps your vision was so bad before the yag treatment that you could not even see well enough to see previously present floaters.  Another thought is that the yag treatment could have left some very substantial pits or damaged areas in the implant.  That could be very easly ruled out with a second opinion.  Finally, sometimes significant dry eyes can cause similar symptoms.  I'm a little disappointed that no one has been able to explain your symptoms.  See your regular ophthalmologist and if no clear answers, see another one for a second opinion.

MJK MD

[NorthernLite]

Just had a touchup laser done for the membranous tissue that has been partially obscuring my vision and causing a flickering when I move my eye up and down and side to side this past 7 mos. as well as causing significant glare/shimmering in sunlight and evening lampost lighting.  This membrane was still attached from my first YAG laser and was floating up to central in my vision which caused me so much grief, since I was unsure why this was happening.

In essence, this attached membrane was lasered and today those symptoms are gone.  Of course I still have some dark threads floating around in the vitreous from the lasered membrane.  I cannot believe that this small segment of membrane was responsible for my compromised vision all summer.  

For me, it was an ending to a worrisome problem. For your info and thanks for your initial response.  

[NorthernLite]

Dr. Kutryb,

I mentioned that when I saw my regular opthalmologist, I would let you know the result of my visit in regards to vision problems post YAG Capsulotomy:

After a thorough, dilated exam, he determined that I have two separate problems going on.  He noticed that there is a piece of membranous tissue that is still attached  that floats up in front of my vision when I move my eye from outer field to center.  And, I also have a dry eye that has caused some of the symptoms.  Talk about a double wammy!

At any rate, he will start by lasering the offending membranous piece and I continue on liposec opthalmolic drops for the dry eye portion.  Then, a follow-up with him to see how effective the laser was and for further followup.

So, once again a big thank you for weighing in with your excellent possibilities.  They proved correct.