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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marshgirl | @marshgirl | Jun 5, 2023

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.

whatnow1957 | @whatnow1957 | Jun 5, 2023

Thank you, it’s good to know I’m not alone in this.

khodafez7 | @khodafez7 | Sep 18, 2023

In reply to @whatnow1957 "Thank you, it’s good to know I’m not alone in this." + (show)

I've had this as well after YAG, and am extremely disappointed in my nighttime vision.
Did either of your conditions improve with time or anything done by doctors?

khodafez7 | @khodafez7 | Sep 18, 2023

Are your IOLs multifocal or monofocal?

pierg | @pierg | Nov 2, 2023

I have the same problem, one week after the YAG, and one month after the implant. My night vision is freaking bad with this, and I’m pretty depressed. Since the time of your post, what happened after? Do you still have starbursts at night? Has your vision improved in any way? Thanks.

jimmymel | @jimmymel | Nov 7, 2023

I think you are describing what has happened to me.
After cataract surgery, I had a fold in the bag creating a ray of light extending in my visual field from that went from 7 pm to 1 pm.
Had Yag to take it away, now have bad starbursts around many different lights.
Eye doctors can't find what is causing it. They say the IOL is fine.
I am still looking for answers. Any news from you?

jimmymel | @jimmymel | Nov 7, 2023

In reply to @pierg "I have the same problem, one week after the YAG, and one month after the implant...." + (show)

Please see my post on this subject , I am similar.
Jim

fathead | @fathead | Dec 7, 2023

Had a lens implant and had a posterior capsule wrinkle for which I had YAG PCO. I immediately had night time starbursts. Support staff talked to me and examined me and said everything looked good. Finally my doc did a non dilated light exam which revealed my pupil was dilating larger than the PCO hole. Small touch up of the peripheral PCO cured my starbursts.

lornam | @lornam | Dec 14, 2023

Where did you have this done?

pierg | @pierg | Dec 17, 2023

In reply to @jimmymel "I think you are describing what has happened to me. After cataract surgery, I had a..." + (show)

Hi, I’m still having those starbursts now, but they slightly decreased over time. It’s a complicated story, but I have light adjustable lenses that required a few time spaced adjustment sessions after the Yag, so that’s why I took a long time to reply to you. My doctor says that the capsule pierced hole is too narrow and that could cause the starbursts. He promised to slightly enlarge it after all my adjustments and lock-in are done, which leads me to after the holidays. I’ll let you know by then.