PCO and Yag Laser

[rossagrant]

Hi there,
I'm 25 years old and have retinitis pigmentosa which has led to needing cataract surgery on both eyes, completed 3 weeks ago.
Now apparently with R.P you get PCO much faster and much more aggressively than usual and this has already began to happen I think. I am getting lots of glare again in the eye that was done first, it is very cloudy and vision has gone from clear to very blurred.
Now I am seeing my surgeon at the end of this week and I was just wondering if it is safe to use YAG after only 3 weeks?
Also what happens to the sections of posterior capsule that are removed? Are they vaporised or just left to hang around the eye which may create more floaters?
Any advice on this would be great? Thanks in advance!

[Michael J Kutryb, MD]

Wait until at least 2-3 months for yag.  If you do it too soon, there is a greater chance of implant moving or falling out of the capsule.

MJK MD

[rossagrant]

Thanks so much for the information, it's very reassuring. The PCO is very annoying and to wait 3 months may be a bit too long as it's already at quite an advanced stage after just 3 weeks! What are the main risks if it is done, say when the implant has only been in one or maybe 2 months? Is it a matter of waiting for the capsule to seal itself around the implant again and if so what are the timeframes on this occurring? It's just in an ideal world I would like clear vision for Christmas and would love to get back to work ASAP!
Thanks one again!

[Michael J Kutryb, MD]

Exellent questions.  Yes the cataract that you get with RP is often a PSC cataract and can be difficult to peel the last remnants from the posterior capsule.  Thus it is not unusual to need a YAG laser capusulotomy in a few months after the cataract surgery.  Very common.  Normally, I would not do the yag laser until the implant has been the eye at least a few months - preferabley 3 months.  Also if you do it any sooner than 3 months - the insurance company may want a detailed expanation as to why.  So usually wait 3 months unless patient is very impatient.

Where do the pieces go - they just break up into small particles, fall to bottom of eye and are absorbed naturally over time.  Nothing at all to be concerned about.  Sometimes you will notice extra floaters for a week or two.  YAG laser capsulotomy is very safe and about 99.5% effective and complication free.  Very easy, quick, you feel nothing, no recovery time.  Basically, the easiest thing you will ever have done.  I usually use an anti-inflammatory drop for 5-7 days afterwards to reduce the very rare chance of inflammation.

MJK MD