Positive Photopsia after YAG Capsulotomy

Posted by whatnow1957 @whatnow1957, Jun 4, 2023

Hello to all.
After cataract surgery (L) on 1/23/23, I had a positive photopsia from a wrinkle in the capsule. Sky to ground, 40 degree single large “ray”, pretty much at night with leds, etc. Had yag procedure 5/9/23 because with time it never resolved. When I walked out of the office was seeing multiple thin rays. Hoped was due to dilation.

Nope, still have them, with inside leds, and most outside light sources after dark. Starts with one thin vertical ray, another ray appears, to make an X, then it’s a starburst of multiple rays, thin, but multiple. They can rotate, and the primary wave can often have a rainbow sheen to it. From a side eye view, the rays look thin, slightly curving, hydra-like, often seeming to cross over my face.

I have a pvd in both eyes, a “fish hook” image I can see from the retinal area of the detachment, and can see the vitreous sac “moving” as I turn my gaze side to side. I’ve pretty well adapted to that. Also have very dry eyes.

I would appreciate feedback from folks experiencing similar complications, what you were told caused them, and ways taken to resolve.

I have an Alcon Clarion lens, due to small cataracts causing night blindness, set for distance, +23.5. Minor astigmatism.

It’s depressing, since I see 20/15 distance, and the visual complications are severe enough that I have not even attempted to drive…

Have the after check with dilation coming up soon, hope a reason is found. Thank you.

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@jimmymel

Did you get the hole larger and has it helped?

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Yes, she touched up the lasered capsule hole. It definitely helped. It didn't 100% remove the starbursts and streaks of light but I would estimate it took care of 70% compared to prior laser treatments. It was definitely worth the extra procedure!

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To whatnow1957, I developed the same 40 degree single large “ray”, especially at night with street lights and headlights immediately after surgery. Also during the day with overhead recessed lighting. I haven't had yag as yet due to my concerns about the outcome post yag described on this and other forums. Can you let me know if the your symptoms post yag have improved with time? Many thanks.

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@runs2

Yes, she touched up the lasered capsule hole. It definitely helped. It didn't 100% remove the starbursts and streaks of light but I would estimate it took care of 70% compared to prior laser treatments. It was definitely worth the extra procedure!

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To runs2, To make sure I understand correctly, did you initially have the light rays on either side of light sources after cataract surgery as described above? When you mention prior laser treatments, are you referring to yag laser treatments? If yes, did you have the initial yag followed up by one more (or more than 2 treatments total)? I apologize for all the questions!

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Yes, I initially had the yag laser treatment for the back side of the capsule had slightly “wrinkled”. This caused the starbursts if looking at bright lights, especially at night, oncoming cars, room lights even the tv. I was able to convince her to “touch up” the hole by enlarging it.

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@runs2

Yes, I initially had the yag laser treatment for the back side of the capsule had slightly “wrinkled”. This caused the starbursts if looking at bright lights, especially at night, oncoming cars, room lights even the tv. I was able to convince her to “touch up” the hole by enlarging it.

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Thanks runs2. I'm happy you achieved improvement in your symptoms! Interesting that you had to convince the surgeon to do the touch up. Apparently she was reluctant?

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@marshgirl

I have positive dysphotopsia in both eyes after cataract surgery. Alcon acrylic lens set for distance, so I just wear cheaters for readers (1.25 strength). My eyes are a bit complex, since I see basically left eye dominant from strabismus. LED lights, car lights, inside LED’s create huge beams (rays) of lights at about the 2 o’clock and 8 o’clock position. Driving at night is awful and I only attempt it locally- never in busy city traffic!
The moon even gives out weird fuzzy glow around it now.
I have a slight wrinkle in the left eye outer edge. Right eye more central wrinkle . However my vision is 20/20. I was advised to not do YAG unless my vision deteriorated. I’m 15 months post op on right eye and 10 months out left. On top of those issues I still see in lower light conditions the outer edges of my implants . They say your brain adapts. Mine didn’t.
It’s depressing and annoying. I too have dry eyes and blepharitis all from the surgery . I do everything - drops, heat packs twice a day for 10 minutes - everything for the dry eye syndrome and nothing seems to help. At the same time as my cataract surgery they did glaucoma surgery for narrow angle glaucoma on both eyes. So I’m no longer on Latanoprast. Those drops also contributed to dry eyes.
I will avoid any further eye surgeries unless it’s something so critical I have no choice. I have great sympathy for all of us dealing with PD- it’s life changing and not in a good way.

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I see you got it all, like I did.
I’m very discouraged. My latest is the blepharitis with multiple styes and eyelash mites. I’m 8 months out and I’m always in his office. I hate driving at night now. I even went back for laser for the cloudiness after the second eye was done. Not a happy camper.

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