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YAG treatment

Hi ,
I am 54 years old lady. After a year of cataract surgery in my right eye, it develops posterior capsule opacity. I am beginning to experience blur and astigmatism type of vision . I am hesitant to do YAG treatment as I am concern about retinal detachment risk and other possible risks. Because of these complications, I hold on to the left eye cataract surgery. I would be grateful if anybody can share the experiences.
1) How is the vision after the YAG treatment ? Is it advisable to delay till it disrupts daily activities?
2) After YAG treatment, can IOL be extracted and replaced with new lens if necessary ?
3) Without posterior capsule to hold the IOL in place, is there danger of dislocation of IOL or vitreous fluid flow to the anterior part of the eye ? If so, what will happen to the eye and vision?
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233488 tn?1310693103
MEDICAL PROFESSIONAL
Yag laser capsulotomy is the easiest and simplest eye surgery that ophthalmologists perform within the eye. Surgery is generally indicated when vision is unsatisfactory with the eye and the cloudy posterior capsule is the causes. The risk of a retinal detachment for MOST eyes (unless their is a pre-existing major risk factor such as high myopia) is less than 1%. Discuss with your surgeon whether you have any additional risk factors.

JCH MD
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Avatar universal
Hello,
Not sure if you will get this after so much time! I had a successful retinal detachment surgery ( vitrectomy with gas bubble) a year ago in April 2015. Just had cataract surgery in that same eye. After the surgery my doctor said I had a posterior cataract and he did not want aggressively " polish" so instead would like to do a Yag treatment right away since my post op vision( one day after cataract surgery) is 20/50 but the lense is cloudy and we can fix it right away. I am wondering if this seems too quick to move forward with Yag so soon after cataract surgery. Also I am concerned with increased risk of retinal detachment. I know that a redetachment with a buckle is unlikely but do not know how risky it is with post vitrectomy redetachment. Thank you in advance for any insight!
Helpful - 0
177275 tn?1511755244
I would suggest you ask your retinal surgeon and that the cataract surgeon also call the retina surgeon and ask for advice. Yag capsulotomy is never an emergency so there would be no problem with waiting. Another thing is that a risk of Yag cap is macular edema (swelling) that might be lower if the yag cap was done in several months.

JCH MD
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Avatar universal
Thank you so very much for your quick reply!! It is very reassuring to be able to get your feedback! I am wondering if that does make sense that during the surgery the posterior clouded cataract was present as well as a nucleous (sp) cataract but the surgeon felt that with my retinal detachment history and vitrectomy in April 2015 (successful until cataract developed) that he did not want to be too aggressive with "polishing the lens" that was left and felt a yag treatment directly following the surgery would be safer. Would there be anything preoperative thing that could have caused this issue with the lense other than he was being very conservative with the lense? Like lense choice or measurement of the eye ect? Doesn't seem to make sense but asking anyway! Apologies,  I realize I am repeating but I guess I'm confused about why the secondary cataract didn't "develop" as it typically seems to do but the cloudiness was actually still present during the surgery and could not be fixed during surgery. Also, my retinal surgeon ( who by the way recommended the opthamolgist) did clear me for cataract surgery and my cataract surgeon informed me to set an appt with the retinal doc in a about ten days following cataract surgery but did not say to check with him prior to this yag.
I'm tested at 20/50 and surgeon said with the yag it would closer to 20/30 or maybe even 20/20. My main concern and fear is a redetachment of the retina... Are the risks as big as it seems from reading all the scary reports on the Internet?? Again thank you so very much for your valuable time and any information you can give. Best regards~
Helpful - 0
177275 tn?1511755244
First in most cases cataracts (and there are many types the most common are nuclear, cortical and posterior subcapsular (psc)) and many times there are more than one, most common is Nuclear/cortical combo.

Most cataracts do not cloud or discolor the posterior capsule  or by used a 'capsular polisher'; the surgeon can clear the posterior capsule. Sometimes this is not possible as the whole capsular wall is discolored or the cloudy area clings to the capsule and will not come off without breaking the capsule. So I think your surgeon likely did the correct thing.

I am less certain about the avisablity of doing the Yag immediately and would suggest one of two options:  1. Call the retina surgeon and ask for his/her advice. 2. postpone the yag until after you see the retina surgeon and they can observe how cloudy it is and what the status of the retina is.  My choice if it were me would be option 2.

JCH MD
Helpful - 0
Avatar universal
Dr Hagen... Again thank you so very much for your response!! I truly appreciate your time and incredibly quick response. Please know how valuable your help is to many people! I will if you don't mind let you know what my retinal surgeon says and the eventual outcome! Last question, how concerned should I really be about retinal redetachment.. ( I have read your many responses to others  ) but statistics can be confusing and so misleading sometimes ....I think I am just looking for reassurance that with okay from retinal surgeon that it is hopefully highly unlikely to occur!!   Again, such a pleasure to be able to communicate with you~ Best regards~
Helpful - 0
1 Comments
One advantage of waiting till you see your retina surgeon before yag is that he/she can "handicap" the risk of RD.  However ball park figures with successful scleral buckle the risk of RD after cataract surgery and Yag capsulotomy probably 1 in 500 to a 1000  Confirm with your retina surgeon
Avatar universal
Is the risk similar with the
vitrectomy surgery and no buckle? And by handicap I assume you mean make sure weak areas are treated with laser? I promise I won't keep asking follow up questions!! Thank you again!
Helpful - 0
1 Comments
It's hard to generalize because retinal detachments look different and have a number of variables such as size and location of holes, degree of myopia and other problems.  So this is a very general statement the ris of 2nd RD probably higher if RD repair done with no buckle.  By "Handicap" I mean your retina surgeon could give you the odds of a RD after cataract surgery and after yag laser capsulotomy.
Avatar universal
Thank you again for your time and valuable insight! I've read many of your posts over this last year and have appreciated your willingness to be available to so many! Many thanks~
Helpful - 0
1 Comments
You are welcome. OMG are we ever having stormy weather here in Kansas City right now
Avatar universal
That's too bad!! :( Not fair of the weather to do that over a long weekend! I'm in Salt Lake City and we are seeing nothing but sunshine!! Sunshine makes everything better :):)
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1 Comments
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