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678451 tn?1226425977

Problems post YAG Capsulotomy

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 and impedes my vision on and off, 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 was frightening to me, but after an emergency visit on a long weekend to an on-call opthalmologist, it was determined that there was no evidence of a retinal tear.  A month later those "branches" subsided.  

Now 6 mos later, I still have cloudy patches across my vision, a blurry, cloudy patch that my vision has to flicker through each time I move my eye and some shadowing.  

I had a routine check with my opthalmologist scheduled last month, but unfortunately saw a locum who dismissed my symptoms as not related to the laser surgery.  I was astounded, since that's when it all began.  I started using a natural tears which has not helped much but I continue to use them.  

My visual acuity is very good in that eye except for periods of cloudiness, and a perception that I am looking through this oiled lens in certain light.

Could you shed some light on what may be the cause.  And, is this something that will go away with time? Hopefully, it is since the opthalmologist can't shed any light on the problem.
10 Responses
668969 tn?1227320803
Dear Northern,

I have only two thoughts if nothing else was found on your exam.
1) Your YAG may have been a little on the small side. That is not bad but some people
can get glare off the edges of the opening.
2) You may have fairly prominent vitreous that is a little cloudy and once the YAG was done, the vision was "better" but the cloudiness was more obvious. This is not uncommon.

I would see your surgeon when your surgeon is in the office to check everything out.
586266 tn?1223817191
I had yag laser twice for a secondary cataract and the cloud is still there. Now my Dr says he thinks it is in the vitreous rather than the capsule. I really do not understand this at all and no one has been able to explain it to me. Do your have any thoughts about this situation? Do you think I ever had a secondary cataract?
668969 tn?1227320803
There probably was a cloudy posterior capsule (secondary cataract) or your doctor would not have done the Yag laser. It is appropriate to do a safe procedure which is easily done (Yag) to see "what is left" and only then would one know that there could be another cause of symptoms. If you are not satisfied, it never hurts to get a second opinion.
678451 tn?1226425977
I saw my opthamologist and after an extensive dialted exam it was determined that there is a piece of membrane that is still attached following the original laser  that floats into my vision when I move from lower outer field to center.  I will have YAG Laser to correct this,  I also got a dry eye which I suspected and for which I am on Liposec opthalmic drops for.  Talk about a double whammy!

Thank You for your time in responding to my question back Nov 11.  I appreciate your time.
678451 tn?1226425977
I have now had the membaneous tissue that was still attached lasered and both the flickering  in my inner visual field and the shimmering and glare of both lights and sunlight in that area have disappeared immediately following.  Thanks for your initial response.  My specific problem has now been alleviated.
Glad to see you are doing better. Your complaints were like mine to a tee. I just had my first yag six days ago and symptoms have not improved. I see the ophthalmologist again in two days and will bring your description of your symptoms with me since I was having difficulty explaining them . Thank you and be well.
Glad to see you are doing better. Your complaints were like mine to a tee. I just had my first yag six days ago and symptoms have not improved. I see the ophthalmologist again in two days and will bring your description of your symptoms with me since I was having difficulty explaining them . Thank you and be well.
Avatar universal
I have had the Yag laser with "hanging chad" so had an enlargement.  However, the optometrist tells me I still have floaters that are not settlling permanently (its been about 6 weeks since second Yag)  She tells me this is unusual and that I may need to see a retinol specialist who will "suck out" the gel thereby getting rid of floaters..And the body will replace the gel...How safe is this? How long should I wait for floaters to settle before going to retinol  specialist.  As with the other authors my vision gets worse when I move my eyes.  Is there anything I could be taking or doing that would keep my floaters from settling permanently?
Avatar universal
Saw your post and I have the exact saw thing! I had the surgery on Monday and am going back tomarrow.....
I will let you know what they found and I would hate to have this permanetely.
Get headaches -better get off the computer since it bothers me....I did get tears after being recommended by the Dr befor leaving.
The paper says I could of driven. I  had a big sun in my eye! It was glare-like the sun was actually in my eye! Honest!
Now it is is like you want to pull somethng out! it feels like something is in there!
NorthernLite you could not have described it any better.......
Going tomarrow morning since my left eye I had done is not as bad-i could live with it but has issues along the same line.
What came of your eyes. Going through same thing now
That posting is from 2012 I doubt you get a response. Suggest you start a new posting of your problem
Avatar universal
I have the same symptoms you have and my Doctor says the same thing that surgery may be needed . But he won't do it for several months to see if gravity make them settle . How has it been for you. And did you have the floater taken out . And did they tell you you may get a detached retina ?  
Avatar universal
Did you ever get a satisfactory conclusion to your issue?  I have the same issue and do not know who or where to go from this point
Those posts are 3-4 years old and I doubt they respond. This is an extremely unusual problem. I would suggest a second opinion from a medical center with a strong ophthalmology department. Possible causes include a edge of the posterior capsule could still be in the visual axis, the IOL could have been decentered, there could be severe lens pitting/marking from the Yag laser, you could need glasses, you could have an unsuspected corneal problem. Where do you live?
My doctor told me that the blurriness Post-YAG surgery was caused by the irregular viscosity of the fluid in the eyeball-and that this occurred in patients who were previously very near sighted.  
What you are describing are vitreous floaters. If that is the cause they should move around when you move your eye and it should usually be possible to find a position where they are not in your way.
Avatar universal
Dear Dr. Hagar,
I had cataract surgery on my right eye March 30. The left eye was done a week later. I noticed a difference in how clear the left eye was immediately although I did see some glare. I went back for my rechecks and said the glare was bad in my right eye and a bit in my left. Just 2 weeks ago he did the YAG surgery on my right eye which has the exact problems as the initial poster stated. It did not "fix" anything. I feel it is worse. I drove the other night and it was terrifying. He was going to YAG my left eye but I said let's leave well enough alone. Besides the "film" or "oil" vision to me, the glare is bad along with being able to see the halo of the lens in both my eyes when I watch tv in the dark or go outside. He did more test. I "see" 20/20. He looked and looked but he cannot "see" my issue.
He is a good and well respected Doctor. Sadly I wish I had left them alone. His only idea was maybe a nerve problem. He said "we'd wait and see". Well, I'm not seeing so well.
So your thoughts are to go to a medical center? I live in southeastern TN. I appreciate any ideas.
Thank You.
Maybe YAG is not the right term. I just know he used a laser to try and correct the issue.
You need a second opinion.  I trained at Emory U Dept of Ophthalmology. One of the best in the world you might arrange a consult there, or at Vanderbilt.
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177275 tn?1511755244
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