YAG Laser Iridotomy Complications

Posted by jigglejaws94 @jigglejaws94, Sep 25, 2016

Has anyone had a laser iridotomy with resultant "ghost images" or a crescent of light in field of vision?

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@jennyone

I have been advised by my ophthalmologist to have a YAG Laser Iridotomy, I am having concerns about this procedure, basically the after effects and or the pain during the procedure, If anyone out there have had this procedure done will you kindly share your experience and after affects. Thank you in advance.

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i’ve had two of those procedures—-PAINLESSLY. After the first, i had an ocular migraine for 24–48 hours. After the second, i was given preservative free steroid eye drops —and had no problems, My vision improved almost immediately after each procedure

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@skysoarer

What is the size of your hole and where was it placed? Mine is very tiny, hardly visible to the naked eye. Nonetheless, I have been experiencing vision problems, as mentioned in my previous comments. I've only had 3 or 4 shots, which were painful but tolerable. Recently, I tried special colored contact lenses, which improved my vision in one aspect. However, the doctor advised against them due to my dry eyes. I'm seriously considering closing my holes and relocating them.

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My hole is about 1mm and it was placed in the 9/8:30 position.

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@blackcat99

Hmmm. I had an LPI on my right eye a couple of weeks ago. It took 117 zaps and my doctors who IS a specialist said that was on the high end. It ended up closing up due to inflammation but I only needed about 10 total during the revision. 300+ sounds like them may not have used the right kind of laser (YAG) or properly aimed for a weak part of the iris.

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What is the size of your hole and where was it placed? Mine is very tiny, hardly visible to the naked eye. Nonetheless, I have been experiencing vision problems, as mentioned in my previous comments. I've only had 3 or 4 shots, which were painful but tolerable. Recently, I tried special colored contact lenses, which improved my vision in one aspect. However, the doctor advised against them due to my dry eyes. I'm seriously considering closing my holes and relocating them.

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@angelg

Did the opthalmologist ever talk to you about lense replacement instead of LPI? Just curious, since this is what I will have done if heaven forbid I have any problems.
Wishing you a speedy recovery.
Thank you for sharing.

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My cataracts is mild and doesn't affect my vision. Basically, no reputable surgeon will do this for someone young with mild age-related slowly progressing cataracts. Lens replacement is much more invasive and risky compared to LPI. I just had my revision surgery (which is rare but DOES happen). My hole is now bigger and the doctor says it will NOT close again, but I'm on an aggressive anti-inflammation routine to make sure.

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@blackcat99

Hi everyone! I'm writing this to help add to the body of information available on this topic. A month ago, my optometrist identified narrow angles in both of my eyes. She then gave me a referral for an ophthalmologist who specializes in glaucoma. The doctor confirmed narrow angles and informed me that as I have a very narrow-angle PLUS mild cataracts (diagnosed at 39; I'm now 42) which will continue to grow and push my iris and cornea even closer together, an LPI is the best course of action. I then spent about two weeks doing my own research (which brought me here) and just generally spiraling due to the many horror stories and imperfect science that is narrow angles and LPI. I had my procedure in late March of this year. Everything was fine and my IOP didn't spike afterwards. The first day without the drops, I was still fine. Then day two I woke up with painful light sensitivity. I went to the doctor's office and was informed that not only was my iris inflammed but my iridotomy hole had apparently closed up in a record 6 days (possibly less). Needless to say I was NOT happy and seriously questioned my doctor and the care that I had received, even though he has all the top credentials. After meeting with him again for a follow-up, going back on prednisolone 1%, and being prescribed a more aggressive preventative routine and strategy going forward, I decided to get the revision done. Mostly because this whole situation is seriously stressing me out and putting my life on hold. In other words, unsustainable. I had the revision and it hurt much more afterwards this time, but took a lot fewer 'shots'. I have very dark irides and it took 117 shots the first time. Advil resolved my pain within 30 minutes and so far I haven't need more. I'm currently on day two of an aggressive course of prednisolone and cosopt. No pain, but I do have a bit of visual disturbance (halos) when I look at recessed ceiling lights but so far no other issues. I'm hoping this minor light issue will go away in a few weeks. Baring no other complications, I will have the second eye done in a couple of weeks.

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Did the opthalmologist ever talk to you about lense replacement instead of LPI? Just curious, since this is what I will have done if heaven forbid I have any problems.
Wishing you a speedy recovery.
Thank you for sharing.

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@laveda

I do live in US. I have thick corneas so pressure runs 19 at the lowest. They do all the testing every 6 months. No glaucoma. My right pupil is large after surgery and he tried restriction drops 2x that temporarily made it a little smaller. He said he’d never seen this with surgery, only with trauma. 300 laser zaps sounds like trauma to me. Eye is so blurry and tender. It aches. Even when I blink.

Jump to this post

Hmmm. I had an LPI on my right eye a couple of weeks ago. It took 117 zaps and my doctors who IS a specialist said that was on the high end. It ended up closing up due to inflammation but I only needed about 10 total during the revision. 300+ sounds like them may not have used the right kind of laser (YAG) or properly aimed for a weak part of the iris.

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@angelg

I'm scheduled for an iridotomy in May, no elevated eye pressures ever. Went to get eyeglasses in Dec '22 and was diagnosed with narrow angles, was told to see an opthamologist in one month. I've been full of anxiety about going blind since then.

I went to see an opthalmologist one month later and only had the gonioscopy done, pressures were normal. MD diagnosed me with Chronic closed narrow angle glaucoma. I asked him why the diagnosis, and he told me to read the glaucoma pamphlet. Asked him why he didn't check my optic nerve or visual fields, do an OCT scan? He said my eyes needed to be dilated for these tests, but I had researched this and eyes do not need to be dilated for a comprehensive exam to rule out glaucoma. While I was in the office, he scheduled me for an iridotomy in 2 weeks?

I was suspicious about the diagnosis and why I didn't have a comprehensive exam with him, I let him know via phone, he then referred me to a glaucoma specialist. I went one month later, (hard to get an appointment). All tests were done, optic nerve was perfect, peripheral vision was normal, OCT scan normal. My narrow angles measured about the same (mild, according to one chart I found )? The glaucoma specialist changed my diagnosis to narrow angles. Said I did not have glaucoma and was confused about the diagnosis. She gave me 2 to 3 months to schedule the LPI, but said the majority of people with my anatomical narrow angles, no glaucoma never have acute attacks, but suggested I have the iridotomy at the 9 o'clock position on the left eye. My eyes are light brown! Will it be noticeable? She said she read a lot of research about less side effects post with the 9 o'clock position. I have a call in for her to return to find out how many patients she's done the laser on at the 9 o'clock position, side effects, and about my daily stress headaches for 23 years, also other things that I didn't mention.

My vision has not decreased, been wearing glasses since a child only inside. I've had a bad astigmatism in left eye since I was 7 years old. Of course I'm nearsighted and the farsighted came with age.

I'm planning on getting a third opinion, have not chosen an opthalmologist specialist yet, since I don't need a glaucoma specialist anymore, hopefully it will be soon.

I'm so nervous about this whole thing, I can't live with side effects from the iridotomy due to my stress level. I work from home every day. I want my life to be normal. I know the devastating effects of angle closure and DO NOT want to go blind or be miserable the rest of my life.

These posts, mostly from 2016 have been mostly helpful, but got progressively more disheartening as they went on due to side effects post LPI. I don't think I have a choice 🙁

Any newer experiences with post laser iridotomies, positioning of the laser shots, especially the 9 o'clock position, and side effects would be greatly appreciated.

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Hey there! Please see my post from 2024.

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Hi everyone! I'm writing this to help add to the body of information available on this topic. A month ago, my optometrist identified narrow angles in both of my eyes. She then gave me a referral for an ophthalmologist who specializes in glaucoma. The doctor confirmed narrow angles and informed me that as I have a very narrow-angle PLUS mild cataracts (diagnosed at 39; I'm now 42) which will continue to grow and push my iris and cornea even closer together, an LPI is the best course of action. I then spent about two weeks doing my own research (which brought me here) and just generally spiraling due to the many horror stories and imperfect science that is narrow angles and LPI. I had my procedure in late March of this year. Everything was fine and my IOP didn't spike afterwards. The first day without the drops, I was still fine. Then day two I woke up with painful light sensitivity. I went to the doctor's office and was informed that not only was my iris inflammed but my iridotomy hole had apparently closed up in a record 6 days (possibly less). Needless to say I was NOT happy and seriously questioned my doctor and the care that I had received, even though he has all the top credentials. After meeting with him again for a follow-up, going back on prednisolone 1%, and being prescribed a more aggressive preventative routine and strategy going forward, I decided to get the revision done. Mostly because this whole situation is seriously stressing me out and putting my life on hold. In other words, unsustainable. I had the revision and it hurt much more afterwards this time, but took a lot fewer 'shots'. I have very dark irides and it took 117 shots the first time. Advil resolved my pain within 30 minutes and so far I haven't need more. I'm currently on day two of an aggressive course of prednisolone and cosopt. No pain, but I do have a bit of visual disturbance (halos) when I look at recessed ceiling lights but so far no other issues. I'm hoping this minor light issue will go away in a few weeks. Baring no other complications, I will have the second eye done in a couple of weeks.

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@angelg

How is your eye? Did you get to see the main ophthalmologist or is your regular MD helping? Hope it's better

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No improvement. Went to the main opthamologist specialized in glaucoma and he said pupil enlarged is permanent from trauma. Have a new cataract. Am referred to Moran Eye Center glaucoma specialist in February. Hope he can help.

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@angelg

I read every article imaginable before I decided not to have the iridotomy, but yours was an emergency unfortunately.
I looked on Youtube and found the procedure being done by a Dr. Rami Shasha, a renowned Ophthalmologist. He seems to work in the US and Canada. I looked to see where he worked, but could not find a specific hospital.
I checked Linkedin and found him.
Rami Shasha
Ophthalmologist
Grey Bruce Health Services
Owen Sound, Ontario, Canada
Perhaps you can contact him and find out if he still does the procedure and where?
Here is the contact number from Linkedin.

You'll have to get on Linkedin, to contact him
linkedin.com/in/rami-shasha-8010ba42

Please let me know if you can find out where he does the McCannel Suture technique.

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Well, I'm not sure if it was an emergency situation. I don't want to get into details, but the night shift allowed me to sleep with an IOP of 52. Diuretic didn't help me at all. They were uncertain about giving me Pilocarpine. In the morning, the new staff administered it, and my pressure normalized to 14. Then, the GS arrived and examined my angle. Interestingly, a few months ago, I was told it was impossible to have an angle-closure attack because I have wide angles—this has been the verdict since 2010. Anyway, the GS informed me that she would perform a procedure with NO downsides. I am very upset that my doctor misled me, even though this is the protocol they are supposed to follow.
I will reach out to the mentioned doctor if conservative measures prove ineffective. Thank you!

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