YAG Laser Iridotomy Complications

I had the laser iridology done in April of 2021 by Midwest eye center.

I was told I had narrow canals in my eyes. Weird because no one has ever mentioned it before and I have been to eye doctors many times for dry eyes.

Suddenly I have narrow canals?

Was told I needed the surgery to prevent glaucoma or I could go blind. My eye pressure was low and I had no real vision issues at all. Vision was good. I did have dry eyes issues however..

Was told the procedure was necessary. I asked repeatedly if the procedure would affect my vision. I was told it would not affect my
vision at all.

But that was a LIE!!! My vision was affected. I have a constant white light in my eyes. I feel like I am looking over a white cotton ball all the time. It’s much worse outside.

I am furious about it and it has really affected me a lot.

I go back and tell them and then am told that it’s rare that it happens. Wow!! Now I’m told.

While I’m there I hear a patient in next room being told exact same thing. Makes me wonder if this is being done to patients who really do not need this procedure. I have never been told I had this problem by any other eye doctor.

Beware of this procedure if you do not really need it. It can affect your vision.

I should have researched it. Once again I trusted a doctor that has now injured me and caused me permanent damage. I’m furious.

Welcome @am155 and @frustrated915. I'm tagging fellow members who have experience with YAG laser treatment like @rwinney @jigglejaws94 @jennyone @lioness @quincy9 @isaosunagatty.

Am, what did your doctor say about the pressure?

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

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.

I had the laser iridology done in April of 2021 by Midwest eye center.

I was told I had narrow canals in my eyes. Weird because no one has ever mentioned it before and I have been to eye doctors many times for dry eyes.

Suddenly I have narrow canals?

Was told I needed the surgery to prevent glaucoma or I could go blind. My eye pressure was low and I had no real vision issues at all. Vision was good. I did have dry eyes issues however..

Was told the procedure was necessary. I asked repeatedly if the procedure would affect my vision. I was told it would not affect my
vision at all.

But that was a LIE!!! My vision was affected. I have a constant white light in my eyes. I feel like I am looking over a white cotton ball all the time. It’s much worse outside.

I am furious about it and it has really affected me a lot.

I go back and tell them and then am told that it’s rare that it happens. Wow!! Now I’m told.

While I’m there I hear a patient in next room being told exact same thing. Makes me wonder if this is being done to patients who really do not need this procedure. I have never been told I had this problem by any other eye doctor.

Beware of this procedure if you do not really need it. It can affect your vision.

I should have researched it. Once again I trusted a doctor that has now injured me and caused me permanent damage. I’m furious.

I have very similar annoyance in one eye . My doctor is supposed to be the best . The left eye is fine but my doc said he put a nice large hole in my right eye because am young . Anyways he told me that after the procedure and now I have an extra image beside any bright light . So please make sure your doctor communicates with you about the location and size of the hole. Good luck every one and talk to couple of doctors if you have questions.

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.