YAG and Crystalens

I had a Crystalens implanted on 3/25/2008 and a Retstor on 4/22/2008.  At my last exam (1 week post op on Restor) my doctor informs me that I will need a YAG on my Crystalens eye at some point in time.  I really hate to hear that as I have been very fortunate with my two surgeries and don’t want to risk my new found vision.  I have a few questions regarding this procedure.

1.  Is there more risk on doing a YAG with a Crystalens than with an IOL that is not designed to move?  

I saw somewhere that the lens could move (as it is supposed to with a Crystalens) and allow the vitreous (fluid behind the lens? I hope that is the correct term) to escape into the lens capsule (which now has a hole from the cataract surgery).  

2.  Is the lens normally expected to stop the vitreous from moving forward after a YAG?

3.  What happens if the fluid were to escape around the lens?

4.  What happens if during a cataract surgery the membrane is punctured or compromised in some way?

This was a concern before my surgeries because I had Posterior Polar Cataracts and the doctor told me that I would not be able to receive a Crystalens if the member was compromised during the cataract extraction.  Now I am wondering what would have happen had they lost containment of the vitreous.

5.  What is the possibility of the lens itself being damaged during this procedure?  I saw somewhere where a doctor used the phrase “Laser scuffs”.  Yikes!


My vision was degrading so fast that the decision to have the cataract surgeries was easy. However now that I have good vision I am hesitant to take any risk.


Thank you,

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

1. Yes
2. usually but not always
3 If the fluid is formed vitreous it can move the IOL or prevent it from focusing.
4. Rupture of the posterior capsule is the most common complication of cataract surgery and occurs 2-4% of the time. If necessary a vitrectomy is done and the IOL inserted. If capsule is torn consideration might be given to not using a multifocal and inserting a monfocal
5. Laser marks are generally not a problem and people tend not to notice them even when there are a lot of them. Laser marking of IOLs are often not preventable.

JCH III MD

[bstaggs]

Thank you for your answers.  Sounds like I will hold off as long as possible.

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

Even in a multifocal IOL yag capsulotomy is not a high risk procedure if the capsule gets really cloudy.

JCH IIMD

[bstaggs]

A related discussion, YAG and Crystalens was started.