YAG Laser Iridotomy Complications

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.

I informed my doctors that, in many cases, the positioning of the hole is temporal, as you mentioned. However, right after that, she informed me that it would be very bad. During my next visit, I plan to ask her why. Many specialists even advise selecting the right position based on individual anatomy, preferably at the 3 and 9 temporal positions, as far away from the eyelids as possible (source: MD Roundtable: Iridotomy Decisions for the Narrow Angle.) Dr. Asrani's last comment supports the same viewpoint.
- Please search it online as I am not eligible to post links as I am newly registered -

I was surprised when my doctor had never heard of such a side effect. Nonetheless, after conducting a comprehensive online search, it seemed that the McCannel structure could be a solution for me (source: McCannel Suture Technique Resolves Persistent Dysphotopsia Following Laser Peripheral Iridotomy in Phakic Eyes). However I don't have Phakic Eyes but these patients have their original lenses just I have.

My doctor informed me that she sutures the iris quite frequently. In my case, there are two options. One involves potential damage to my lenses from the suturing process, necessitating the replacement of my original lenses with intraocular lenses (artificial). (I am too young for this)The other option may involve reaching the hole from the outside, but this is considered very challenging. Since the McCannel suture is a US invention, it is more likely available there than here. Many doctors refer to this technique in cases similar to mine. I also came across an individual whose hole was successfully sutured; however, it didn't help much because his eyes were blue. Fortunately, I have brown eyes.

On a side note, my glaucoma was well-treated with two types of eyedrops. In 2022, my eyes were dilated, and nothing went wrong. However, I underwent two laser procedures since then to eliminate the need for any eye drops. The first procedure, SLT, was successful, allowing me to discontinue one eye drop. The second, femtosecond laser trabeculectomy, is still in the research phase and is only available in my country. God knows but may be these procedures affected my angles. The first was successful, but the second had no beneficial effect. I was told that I was the 1 in 1000 case where the procedure did not work as expected. 🙁

I am not in a rush as some doctor advice it would be better and it resolves on there own. However based on the comments on internet I am very sceptical. Of course I will try more contact lenses and see how improve my quality of my life.

Anyway, I really appreciate your effort to convey my message to your GS. Let's see if she has any suggestion.

I informed my doctors that, in many cases, the positioning of the hole is temporal, as you mentioned. However, right after that, she informed me that it would be very bad. During my next visit, I plan to ask her why. Many specialists even advise selecting the right position based on individual anatomy, preferably at the 3 and 9 temporal positions, as far away from the eyelids as possible (source: MD Roundtable: Iridotomy Decisions for the Narrow Angle.) Dr. Asrani's last comment supports the same viewpoint.
- Please search it online as I am not eligible to post links as I am newly registered -

I was surprised when my doctor had never heard of such a side effect. Nonetheless, after conducting a comprehensive online search, it seemed that the McCannel structure could be a solution for me (source: McCannel Suture Technique Resolves Persistent Dysphotopsia Following Laser Peripheral Iridotomy in Phakic Eyes). However I don't have Phakic Eyes but these patients have their original lenses just I have.

My doctor informed me that she sutures the iris quite frequently. In my case, there are two options. One involves potential damage to my lenses from the suturing process, necessitating the replacement of my original lenses with intraocular lenses (artificial). (I am too young for this)The other option may involve reaching the hole from the outside, but this is considered very challenging. Since the McCannel suture is a US invention, it is more likely available there than here. Many doctors refer to this technique in cases similar to mine. I also came across an individual whose hole was successfully sutured; however, it didn't help much because his eyes were blue. Fortunately, I have brown eyes.

On a side note, my glaucoma was well-treated with two types of eyedrops. In 2022, my eyes were dilated, and nothing went wrong. However, I underwent two laser procedures since then to eliminate the need for any eye drops. The first procedure, SLT, was successful, allowing me to discontinue one eye drop. The second, femtosecond laser trabeculectomy, is still in the research phase and is only available in my country. God knows but may be these procedures affected my angles. The first was successful, but the second had no beneficial effect. I was told that I was the 1 in 1000 case where the procedure did not work as expected. 🙁

I am not in a rush as some doctor advice it would be better and it resolves on there own. However based on the comments on internet I am very sceptical. Of course I will try more contact lenses and see how improve my quality of my life.

Anyway, I really appreciate your effort to convey my message to your GS. Let's see if she has any suggestion.

Two months ago, I underwent Laser Iridotomy, and it has drastically impacted my life. I was diagnosed with open-angle glaucoma a decade ago and had regularly checked my angles, but no one mentioned that they were closed. The procedure became necessary when my eyes were fully dilated, and I experienced a blockage. Unfortunately, I received no information about the potential risks.

Since the procedure, I've noticed two very bothersome white lines instead of just one, as experienced by many others. The placement was at the 12-hour position, but shortly after the procedure, I researched and found that many doctors prefer a temporal placement to avoid such side effects. As I work extensively in front of the computer, this has further worsened my life. Additionally, I've started experiencing eye pain, which even strong painkillers have failed to alleviate.

I've attempted colored contact lenses, but even those with a ring around them provided limited relief and resulted in tunnel vision. Living in these conditions is challenging. How can I locate a surgeon willing to apply the McCannel suture to close the holes? I reside in Europe, so finding a suitable surgeon here would be preferable, but I am open to traveling overseas if necessary.

Tuesday when they are back in office I’ll change to the main opthamologist. If he can’t help I will ask to be referred to the Moran Eye Center. I believe they are the only glaucoma specialists. I am afraid to be blurry for life.

I don't know what to say except I'm so sorry for your experience. I would go to a glaucoma specialist as I've mentioned before, I would not let myself suffer.
There has to be someone who can help you.
Did you go to another specialist, specifically a glaucoma specialist. It doesn't matter if your IOP is within normal range, your eyes should be checked by a Glaucoma specialist, not a regular opthalmologist. Are you seeing the same one who did this iridotomy with the 300 laser zaps?

Update: I still can’t see. Pain is intermittent. It has been almost 3 weeks after 300 laser zaps. Pupil is still large and light sensitive. I can finally see true colors, but very blurry. At post op finally got pressure down to 30. Very frustrated.

That sounds like a good plan. Hopefully it gets better, do you know how many holes he made with the 300 zaps? Is that what's causing the halos and light sensitivity? I researched the pros and cons of iridotomies thoroughly here on Mayo and other places before I decided to just be monitored. My glaucoma specialist said I may have had the narrow angles most of my life. She said that if anything changes, we'll think about lens replacement (my wish) even though I have teeny cataracts now they can still do it and it opens the angles. Please update here in a few days. My heart feels for you.
As for your other post, yes, some people have a lot of trust in their doctors/eye doctors. I went for 3 consults and chose the Glaucoma Specialist I felt the most comfortable with, who didn't threaten that I'd go blind, didn't push the iridotomy on me, and is working with me. We have a very good relationship.

Please don't beat yourself up for what happened. I have a good feeling you'll do what's right and find someone who can help you if your eye doesn't improve. Hopefully it will for Christmas.