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Glare/Light Streaks following YAG laser for PCO
I am glad that I found this site months ago, and that I was able to share my cataract surgery experience and obtain information from others that were also having issues. Writing about my experience has been cathartic for me.
I write now due to a complication from the Yag laser procedures I had on both eyes about 6 days ago due to posterior capsular opacification (pco) in one eye that affected by vision.
Maybe others have had a similar experience with yag and have information or comments to share.
As background, I had cataract surgery in my right eye four months ago and in right eye 3 1/2 months ago. As a result of the first surgery on my right eye, I developed a long linear light streak (maddox rod effect). While I was informed that the Yag laser could correct the issue, I made the decision to wait until my vision declined due to pco before undergoing the yag. Little did I know that pco would happen so quickly, less than four months after surgery.
In addition to confirming pco in the right eye, the surgeon also informed me that I had a similar level of opacification in the left eye even though I wasn’t aware of any vision loss in that eye so on his recommendation I agreed to the Yag procedure for both eyes.
I was informed that the Yag would also fix the wrinkle in my right eye capsule that caused the maddox rod effect.
While the Yag procedure restored the vision decline in my right eye and eliminated the 45 degree linear maddox rod line, it created a number of new thinner lines of glare that twirl/change from time to time. It is annoying and disappointing, particularly since I did not have much glare at all in my left eye prior to the yag.
I wonder from others who may have suffered ‘glare’ ‘light disturbance’ issues from Yag whether their situation improved over weeks or months without intervention and whether they did anything about it.
It may just be a matter of living with it - it's unpleasant but there are far more serious conditions that can occur post cataract or yag surgery.
I very much doubt that I will undergo any further surgical or laser procedures unless my vision deteriorates.
I do wish to find out the cause and reason for the visual disturbance. Maybe the glare is a result of damage to the IOL or perhaps the ‘hole’ created by Yag is too large ….all speculation on my part.
My current plan is to wait at least several weeks or more before making an appointment with my surgeon to address that question in the chance that the situation improves.
Thanks for reading this
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I'm so sorry to hear about the light streaks and glare. Not sure if you've come across the patient info forum in researching all things cataract. I just tried googling:
patient.info forum yag
This retrieved numerous discussions related to yag, including an informal survey of patient experiences.
I've been struggling to understand why so many report complications from yag. If I understand correctly, yag is effective for pco and the maddox rod effect but not for positive dysphotopsias. I'm wondering if those who experienced relief from the maddox rod effect and pco, but then developed other light related aberrations afterward, may have had more going on than just the maddox rod effect post surgery, which were perhaps not noticed due to the severity of the maddox rod effect.
Thank you Tillymack for the information. I read through many of the postings on yag on the patient.info site. I am depressed and upset about it but I realize there's nothing I can really do about it. I can still drive safely at night and will just have to adjust to it. I just hope my anger and continual compulsion over this subsides with time. Post cataract, post yag, things can get far worse than the glare and light-streaming issue even many months after the procedures. That's what scares me With my retinal issues in the past and now this macular pucker, I am just hoping my vision remains good and stable.
I will probably send an email to my surgeon's clinic to document the issue and, unless other issues surface in the interim, request an appointment and a referral to a retinal specialist later this year. I may wait a few weeks before doing so and will be careful in the tone of my note. I will need their help going forward, and it is a highly regarded practice. I can always ask my optometrist for a referral to another cataract surgical facility if I am not satisfied with the response I get.
I understand how you feel as I feel the same. Can you let me know if the glare and light streaks have gotten worse since right after yag or are they stable? Overall, do you feel having the yag was worth it since you no longer have the maddox rod effect and PCO, or are the new glare and light streaks just as bad or worse? I hope you've experienced some improvement in your overall vision!
Hi Tillymack,
I am glad I have you and others to communicate with who understand what each of us is going through - the uncertainty, the fear, the concern with what's ahead.
To answer your questions above,
1. the glare and light streaks have been stable since the Yag last Tuesday (or at least from the day after since my eyes were heavily dilated on the day of the procedure).
2. I really had no choice in doing the Yag for my right eye since I noticed a decline in the vision in that eye which had been at 20/20 and had probably dropped to something like 20/30. It was time to see the surgeon to confirm that the decline in vision was due to pco and not some other issue. It was also the eye that did have the maddox rod line. Even though I now have multiple very thin less bright (fainter) lines in that eye, I would say that eye is an improvement over the thicker singular static maddox rod line. Not what I had hoped for but at least somewhat better.
3. I did not notice any vision decline in my left eye, but as I my surgeon said I had a similar level of pco in that eye as I had in the right, I went with his recommendation and agreed to the yag. A decision I regret. I should have waited until I noticed a visual decline. I shouldn't have been so trusting but that probably happens to a lot of us when we are dealing with MDs who have the knowledge and we don't. Anyway, I did not have much of a glare issue in that eye before - certainly nothing that was bothersome. As with my other eye, I have some multiple thin lines in that eye too. So, yes, I am kicking myself for agreeing to do the yag on that eye
Despite these light streaks, I'm more concerned about the development of more serious complications in the months ahead given my history of retinal holes, tears, and now being told that I have a macular pucker (stable, no visual problem yet). But we just have to take each day as it comes. Hard to do but live in the present and try not to worry about something that might never materialize
4. Yes, the yag did restore my vision in my right eye. I assume it's back to 20/20 or thereabouts. Again, I didn't notice any decline in my left eye so that seems the same. I had a fair number of floaters, particularly in my right eye, prior to the yag and knew the procedure might increase their numbers. I noticed a few new ones a day or two afterwards but that hasn't been a concern at all so that's a positive
To add one further comment to my note above, unless the light streaking gets worse or some other complication arises, I expect that I am just going to adjust to the light visual disturbances as opposed to going back to my surgeon to find out about a correction. Even if there is a yag adjustment to be made regarding the holes, I don't think I would not want to do it within months of last weeks procedure
I'm glad your symptoms are stable and that your clear vision is restored. That sounds great! Did your surgeon suggest a follow up visit to check your eyes after the yag?
Could you describe the glare you're experiencing now? I experience slight glare (other than the Maddox Rod Effect) when working on my computer when I blink. Is it like that?
I remember seeing multiple thin light rays extending from street lights before this last surgery. It was nothing that would interfere with night driving. My surgeon at the time said it was probably dry eyes and recommended more frequent OTC drops. I was used to huge starbursts from head lights, probably as a result of cataracts or maybe I had them even before that but don't remember. Does that sound the same as you're experiencing now...?
Hopefully your retinal and macular issues will remain stable too. Do you see your retina doctor on a regular basis to check?
Yag follow-up: No, the surgeon didn't suggest a follow-up. I asked if there was one and he said 'if there is any issues we're here'. I live close, within walking distance to their office, and I've never had a problem getting an appointment within a few weeks and know that if I have a more urgent issue they would get me in right away.
Glare: I find it hard to describe. Unlike the static long maddox rod line, I now have more multiple thinner, more faint lines, moving rays can apply at times, somewhat similar what you were describing but far worse than the glare I was experiencing before the cataract surgeries....also huge starbursts from headlights you describe also sounds similar. It's just weird - but it's only been a week and I am crossing my fingers that I will adjust better. Doesn't interfere with my driving either.
Retinal Surgeon. Yes, I see one yearly and will probably make an appointment for end of the year or early next assuming no issues surface in the meantime.
Hi again,
I realized yesterday that the starbursts from street lights and headlights since cataract surgery are actually positive dyspotopsia, so it seems I have both PD and the maddox rod effect. Looking again at your message, would you say you had the same? The reason I ask is that my second opinion cataract surgeon is now not as interested in moving forward with my second eye or yag laser without my confirming that my vision is compromised (second eye) or very compromised (yag laser).
Hi Tillymack,
Regarding your question above, before my yag surgery, I think I only had the maddox rod streak in my right eye. If I did have some pd in that eye as well - and I may have - it was overshadowed by the maddox rod light streak. I really don't know.
I believe I did have some very mild pd in my left eye but it wasn't bothersome to me at all and was largely overshadowed by the maddox rod light effect in the right eye. I know I did have some wrinkling in that left eye as well so whether it was PD or not, I don't really know but my guess is that it probably was but quite mild.
If you like and trust your surgeon, I suppose you had best follow his/her advice or obtain another opinion. My general thinking now whether it's about going ahead with cataract surgery or the yag laser, I would only do so if your vision is compromised and is bothersome to your life style. That's kind of my philosophy with any surgery - it's a last resort or it reaches a point where waiting any longer would make the surgery more complicated or problematic.
Thanks Mark!