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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runs2 | @runs2 | Apr 23 4:15pm

In reply to @jimmymel "Did you get the hole larger and has it helped?" + (show)

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!

tillymack | @tillymack | Aug 7 10:50am

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.

tillymack | @tillymack | Aug 7 11:00am

In reply to @runs2 "Yes, she touched up the lasered capsule hole. It definitely helped. It didn't 100% remove the..." + (show)

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!

runs2 | @runs2 | Aug 7 12:26pm

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.

tillymack | @tillymack | Aug 7 12:39pm

In reply to @runs2 "Yes, I initially had the yag laser treatment for the back side of the capsule had..." + (show)

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?