YAG Laser Iridotomy Complications

Good morning. I just wanted to share my experience with the group. I had a laser iridotomy procedure done to both my eyes. My right eye was done last week and my left eye was done yesterday. I first went to my optometrist about 6 months ago due to the fact that I had a weird feeling in my right eye - a feeling like there was fluid building up in my eye and had headaches. The dr said it looked like I had narrow angles and sent me to an Opthamologist. At that appt she said that I do have narrow angles and scheduled me in for a laser iridotomy the following month. I think I was in shock at the appointment and didnt ask all the questions I had. I ended up spending a lot of time online connecting with people who had the procedure and reading so many posts and horror stories about the actual procedure and the possible side effects. There were some positive experiences as well. I was so freaked out that I almost cancelled my appt even though I was still experiencing symptoms. Going online can be scary. I was so scared that entire month before my appt. I did go ahead with the procedure on both eyes. The right eye last week and my left eye yesterday. I would like to let you know my experience. I understand that everyone is different and will experience different things and in no way am I trying to downplay the experiences of others but only want to share my experience to try to help others. Before my appt I did take 2 tylenol as I heard that some people get awful headaches from the drops they use to constrict the pupils. At both appts I did not experience any headaches or pain from the drops. Right before the laser I had the numbing drops put in. Next is the lense thing they put on your eye that has gel on it. It didnt hurt just felt a bit weird. I was told a specific area to look at. All I could see was the gel....no lights or anything. The sound of the laser wasnt loud at all...just a clicking sound. Didnt startle me at all. The right eye took about 8 times and I could feel something only with the last 2 lasers. Wasn't painful at all!!! Felt like I got something in my eye. My experience with the left eye was almost the same except that eye was only lasered 4 times but my eye pressure went up afterwards which I got drops for that I will use for a week and will use the anti inflammatory drops for 4 days. Fortunately I haven't had any side effects really. My eyes are/were sensitive to lights and screens for a few days after and I haven't noticed anything else except that I dont have the headaches anymore and that feeling of fluid build up has gone away. I hope this might help someone. I was so scared going in I was actually surprised that I did. I go in a month for a follow up appt to make sure everything looks good.

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Unfortunately it happens to some patients. It is called a dysphotopsia. I had bilateral peripheral iridotomies over two years ago and I still have residual crescent of light that I can sometimes see. It is the worst when watching a movie on our big screen TV, when driving in sunlight without sunglasses or when looking directly towards a window that is too bright. I doubt mine will ever change as it has remained essentially the same since fall of 2016. I will say that there have been stretches of time that go by that I don't seem to notice it as much but then later will be bothered again. Sorry to hear that you are experiencing this.

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Good morning. I just wanted to share my experience with the group. I had a laser iridotomy procedure done to both my eyes. My right eye was done last week and my left eye was done yesterday. I first went to my optometrist about 6 months ago due to the fact that I had a weird feeling in my right eye - a feeling like there was fluid building up in my eye and had headaches. The dr said it looked like I had narrow angles and sent me to an Opthamologist. At that appt she said that I do have narrow angles and scheduled me in for a laser iridotomy the following month. I think I was in shock at the appointment and didnt ask all the questions I had. I ended up spending a lot of time online connecting with people who had the procedure and reading so many posts and horror stories about the actual procedure and the possible side effects. There were some positive experiences as well. I was so freaked out that I almost cancelled my appt even though I was still experiencing symptoms. Going online can be scary. I was so scared that entire month before my appt. I did go ahead with the procedure on both eyes. The right eye last week and my left eye yesterday. I would like to let you know my experience. I understand that everyone is different and will experience different things and in no way am I trying to downplay the experiences of others but only want to share my experience to try to help others. Before my appt I did take 2 tylenol as I heard that some people get awful headaches from the drops they use to constrict the pupils. At both appts I did not experience any headaches or pain from the drops. Right before the laser I had the numbing drops put in. Next is the lense thing they put on your eye that has gel on it. It didnt hurt just felt a bit weird. I was told a specific area to look at. All I could see was the gel....no lights or anything. The sound of the laser wasnt loud at all...just a clicking sound. Didnt startle me at all. The right eye took about 8 times and I could feel something only with the last 2 lasers. Wasn't painful at all!!! Felt like I got something in my eye. My experience with the left eye was almost the same except that eye was only lasered 4 times but my eye pressure went up afterwards which I got drops for that I will use for a week and will use the anti inflammatory drops for 4 days. Fortunately I haven't had any side effects really. My eyes are/were sensitive to lights and screens for a few days after and I haven't noticed anything else except that I dont have the headaches anymore and that feeling of fluid build up has gone away. I hope this might help someone. I was so scared going in I was actually surprised that I did. I go in a month for a follow up appt to make sure everything looks good.

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Hello -- I just had a Yag laser iridotomy done in my right eye about 3.5 weeks ago. The reason is because I have narrow angles and my ophthalmologist said that there was a rapid change in the angles over a four month period -- so much so that he has never had a patient progress so rapidly. Anyway -- I did not find the laser procedure itself to be painful. It felt like a little pinch in the eye and I believe it took about 5 "hits". Unfortunately, my physician didn't really warn me about what the after effects could be. You will likely be given a drug called pilocarpine which causes your pupil to constrict. It apparently also helps with thinning out the iris so that a good spot can be found to place the iridotomy. But it constricts the pupil for about 12-16 hours (or at least that is how long it lasted for me). I experienced very hazy vision for that same length of time also. Felt like I was looking through a brownish wedding veil or through a haze. About an hour after the procedure, I detected a light aberration -- which appeared as a horizontal line of light across my field of vision. Over the next few days, that progressed to more of a blob of light or a crescent of light in the mid to lower visual field. It does not bother me all the time but is worse in bright light and I notice it he most when I drive.

The placement of my iridotomy was in the superior position which is somewhere between 11 and 1 o'clock position. I felt good about that position because my eyelid would cover the iridotomy hole. However, that is not a guarantee that you will not experience dysphotopsia (glares, haloes, crescents, etc) following the procedure. In fact, there is some literature that indicates that some patients still experience this phenomenon even when the eyelid fully covers the iridotomy hole. It is especially worsened if your eyelid only partially covers the hole (and I think that may be my situation).

I spoke on the phone with my doctor the following week. I let him know that I had done some online research and found that there was quite a bit of information regarding the horizontal approach -- at the 3 or 9 o'clock position -- and that the indication was that there was less problems with light aberration at this position. He said that the trend is to do it at the 3 or 9 o'clock position but that he prefers to do it at the superior position based on a study that came out about 10 years ago indicating that 9 percent of people will notice some light aberration in a fully covered iridotomy, 18 percent experience the same with a completely exposed iridotomy site and 27 percent with a partially covered. So he says that the risk of experiencing this doubles with a fully exposed iridotomy. HOWEVER, there is a lot of literature that indicates that the patients who get the 3 or 9'oclock position (referred to as either on the horizontal meridian or temporal position) have far less difficulty with dysphotopsias.

I am scheduled to have my left eye done on October 26th. My physician said he is happy to place the iridotomy in the temporal position, if this is what I prefer. Well, I don't like the weight of the decision on me -- because I'm not a doctor. So I wrote up an email describing my situation and sent it to about a dozen professors specializing in Glaucoma and several of the leading medical school ophthalmology programs. I have received answers back from about 5 physicians. Four of those recommend the horizontal approach. Two of them sent me a reference to a study and if you would like that forwarded to you, you can let me know your email.

It has been frustrating because prior to the procedure -- my vision was perfectly fine. Now, I have to deal with this problem. So I want to do everything in my power to understand and be educated on what the best approach for my left eye. I know that though my vision was perfectly fine and now it is messed up --- that I am a ticking bomb waiting to go off -- and could easily develop acute angle closure glaucoma and be in an eye emergency in short order.

Hope this information is helpful somehow.

Sharon

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Thanks. I am following up and awaiting a phone call from my doctor. n the meantime, I have done some research and have found several studies and mentions that the superior placement (between 11 and 1 o'clock) tend to have more problems with halos, crescents, light problems through that new whole. The main thought is that the tear meniscus at the edge of the upper lid creates a base-up prism effect when overlapping the position of the LPI. One article suggested lifting the eyelid to see if the light resolves -- mine does. Well, I can't sit around lifting my eyelid all the time. BUT, I will not have a superior placement in my left eye. The suggestion is 3 or 9 o'clock position. I never would have imagined that if the LPI was covered with the upper eyelid that there would be a problem. But apparently EVEN in cases where the hole is completely covered with the eyelid -- this problem can occur. Interesting, huh? No fun messing with eyes. Especially eyes that were seeing just fine and now aren't. Blah.

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