cloudy and distorted vision

[mike230]

had a crystalens hd implanted in right eye 8-08, RD and vitrectomy 10-08 and the adhesion that was causing my pupil to remain stuck open was surgically removed 3-09.  Through all of this I was on drops overkill.  I do have a dry eye condition which I seem to be managing quite well.  The dry eye is affecting both eyes.  Moisture goggles help.  Regarding my right eye, my question is (considering secondary cataracts are common in crystalens patients months after implant) with all the fussing around in the eye could I have a secondary cataract:
Fact  The careful examination and OCT report of my entire retina and optical nerves revealed a better than perfect recovery, cornea looks extremely healthy.  
Symptoms I encounter in right eye: light and contrast sensitivity, at sundown vision is a little darker, vision is blurred and distorted at all distances more so at distance.  A crystalens clinical instructor in the midwest has mentioned that the slightest start of debris on over sensitive patients can raise havick.  
With the above comment, would a YAG laser treatment be to my advantage.  Regarding my dry condition, lower were installed, my next appt is 8/10 where my opthamologist plans on expressing my lactrimal glands and if need be install an upper plug in my right eye.  But again with the surgical inventions i underwent in the course of last year, I am just wondering if in fact a secondary cataract is being overlooked,  This whole thing has be a little anxious, I just feel perfect vision is just around the corner, because I know my refraction is actually where it needs to be.

[mike230]

First off what was the cause of your RD.  I had millions of floaters which then after cataract surgery caused the dried up vitreous to pull on the top right hand corner of my retina (vitreous traction)  I caught it very early and thank god it was a macula on situation.  At the time of the repair the surgeon performed a core vitrectomy and got rid of all that old vitreous so there will never be anything pulling on the retina.  

I assume they used the gas bubble to hold your retina flat during the healing process.  The bubble was a pain in the you know what rendering non functional vision for 6 weeks.

With the cycopentolate drops that hold the pupil diolated so they can examine you and to paralyze the ciliary muscles from moving during the healing process in my experience caused my pupil to remain stuck wide open (very disabling vision especially at night driving)

The surgeon who diagnosed and treated this condition had a slit lamp that took zoom photos of the affected area which was an adhesion between the back of the iris and in front of the capsule bag.  Even I could identify this adhesion that is how effective this instrument is.

The surgeon did a procedure called posterior of the synchia which successfully broke up all the adhesions, about 3 months later my pupil has returned to normal to my satisfaction and I am fussy when it comes to my eyes.  

With all this fussing around, I am convinced I have developed a secondary cataract which I know I have all the symptoms.  The OCT machine which X rays the entire retina and back of the eye revealed everything healed up better than normal thanks to another member on this site who strongly encouraged me to take solarray ultrazeaxanthin which was sage advice

If you want, I would be more than happy to e-mail you the surgeon's name and contact info who performed this procedure.  I can say the procedure was a piece of cake.  I hope this helps you and wishing you a successful visual recovery

[MsAnnRN]

I was reading your post and the part about the adhesion causing your pupil to remain stuck open caught my eye.  Did you mean that your pupil had remained dilated post op?  If so, how was your surgeon able to determine this and what is the result of the adhesion removal? My last surgery for RD was March 09 and my pupil has remained dilated much to my dislike. I wish there was someway I could make it normal again!!  It is very noticeable as I have very light eyes.

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

The yag cap does involve much less risk that cataract surgery (which is small risk of complication 2-5%).  The mechanism of increase RD after yag cap is felt to be due to movement of the vitreous body forward through the hole in the capsule.

JCH MD

[mike230]

Just for my own knowledge, how can the yag laser pose a threat to the retina, I thought the capsulotomy procedure is a lot less traumatic than cataract surgery?

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

A yag capsulotomy does increase the risk of an RD slightly. However if you have been treated for a RD and have had laser/cryo/buckle your risks would be LESS than normal

JCH MD

[mike230]

If a YAG is in order having had a very successful RD repair and a core vitrectomy at the same time, does the YAG laser pose any threats to my retina, would I notice any new floaters even though I had the vitrectomy.  Overall my entire eye is healthy except for this bit of cloudiness, there are so many mixed opinions about the capsulotomy

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

Sure its possible you have a cloudy posterior capsule however only direct exam can tell for sure.

RE: dry eyes use the search feature and archives to read about treatment. Most ophthalmologists now us RESTASIS before the plugs (me too) because the plugs tend to fall out or irritate eye and Restasis is such a fantastic medicine.

JCH MD