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?

Liked by agoldstein

@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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One other thing I was going to mention is that — because my angles are so narrow- – I can no longer have a dilated eye exam until the peripheral iridotomy is complete. Dilation of the eye could push the iris and totally occlude the angle – putting my right into acute angle closure glaucoma. As I await my left eye procedure, I’ve been careful to avoid any cold medicines (not that I usually take them anyway) or anything that will tend to dilate my eye — as much as possible.

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@jigglejaws94

I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it — I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.

There is a photo of this lens in this article: http://emedicine.medscape.com/article/1844179-overview

Also, if you would like to see someone getting an iridotomy, here is a video clip: http://www.rootatlas.com/wordpress/video/645/how-to-perform-a-laser-iridotomy-video/

Also, I didn’t mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think — sometimes they hurt for a few days after getting poked at at the ophthalmologist’s office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.

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The after effects/complications of the procedure. Other follow up surgeries

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@jigglejaws94

I forgot to mention that in addition to the pilocarpine drops to constrict the pupil, another drop was given to reduce inflammation and also numbing drops are given. A special lens is placed on the eye that has gel in it — I worried about my blinking but with this lens in place, if you do blink, it just hits the lens.

There is a photo of this lens in this article: http://emedicine.medscape.com/article/1844179-overview

Also, if you would like to see someone getting an iridotomy, here is a video clip: http://www.rootatlas.com/wordpress/video/645/how-to-perform-a-laser-iridotomy-video/

Also, I didn’t mention that following the procedure, I had a fair amount of pain. I took Tylenol (but not ibuprofen or aspirin) before the procedure which was recommended. The pilocarpine is known to give some folks a brow ache. Indeed, it did. My whole eye ached (but I have pretty sensitive eyes, I think — sometimes they hurt for a few days after getting poked at at the ophthalmologist’s office). I needed more Extra Strength Tylenol 3 hours after the procedure and then was concerned when I needed again at just 2 hours. I called the doc on-call and she assured me that since the pain did respond somewhat to Tylenol that it was not pain due to my IOP rising. She advised switching to Advil. I was also concerned because of the haziness of my vision. She said both the pain and the haziness were due to inflammation and to increase the prednisolone drops to get as much on board that night to reduce inflammation.

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I understand. I am anxious about my second iridotomy next week and am hoping for a good result.

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@jigglejaws94, Thank you for sharing your experiences with @jennyone, it’s so nice to have someone who is familiar with a similar situation to help guide or bounce ideas off.

@jigglejaws94, how did your surgery go?

@jennyone, did you decide if you were going to go through with the procedure?

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@jamienolson

@jigglejaws94, Thank you for sharing your experiences with @jennyone, it’s so nice to have someone who is familiar with a similar situation to help guide or bounce ideas off.

@jigglejaws94, how did your surgery go?

@jennyone, did you decide if you were going to go through with the procedure?

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After a lot of research and back and forth emailing with Ian Connor MD — I decided to request a temporal iridotomy on my left eye. My doctor, Dr. Edwards was very fine with that. He had just been to an ophthalmology conference in Chicago and said it is still very much a controversial topic. There are definitely two camps. Anyway, he did do the temporal position. I did not experience any immediate dysphotopsia this time and got on top of the inflammation quicker with additional use of the steroid drops. Next day — I started noticing that I did have some extra light coming into that eye — more like a vertical “hunk” or “chunk” of light — especially noticeable with bright light coming from the left side. It has been a week and this has bothered me less. I am hoping that it improves completely. I still have the more horizontal dysphotopsia on the right side which waxes and wanes, depending on the lighting. So there you have it — I have an iridotomy, one each of the two positions — and have some issue with both. I certainly could have worse vision and more problems than I do from the procedures– so I am thankful. I am also just relieved to stop researching, thinking and spending so much time thinking about what to do about the iridotomy. All done! I will return in two weeks for a dilated exam. Thanks for asking about me.

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Has anyone had both eyes done at the same time? Would you recommend it?

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@tssandy

Has anyone had both eyes done at the same time? Would you recommend it?

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I can’t imagine that any doctor would do both eyes at the same time. Usually you have them done a week apart. I wouldn’t recommend it. In my case, they were about a month apart — as I researched different positions.

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@tssandy

Has anyone had both eyes done at the same time? Would you recommend it?

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Hi Sharon I read ur posts about having a temporal LPI. I’m so glad I found ur posts! They are very informative. How r u doing now?? I had my left eye done a week ago and a day after the procedure I noticed a streak of light in my inferior visual field, it’s very annoying especially when I’m driving. My doctor positioned the hole in between 11 and 1 o’clock. I too read several articles on how temporal LPI actually reduces the chance of having visual disturbances but since it’s fully exposed it still poses some risks. I’m scheduled to have my right eye done in a week but I’m not sure if I should request a temporal placement? Since u had both done, which method caused the least side effective for u?

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@tssandy

Has anyone had both eyes done at the same time? Would you recommend it?

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Hello — I'm glad that my posts helped someone — you! I do still see the crescent of light near the bottom of my field of vision for my right eye which had the iridotomy at about the 12 o'clock position. I don't think I notice it as much anymore. And I only notice it under certain lighting conditions. Bright sunlight is the worst — and especially when driving. I find that wearing sunglasses helps immensely. I was never one to wear sunglasses much but I sure do now. My left eye was the temporal position. I have very little difficulty with any light abberration in that eye. Once in a great while, if the light is very bright and at an odd angle, I will see a little bit on the lateral side of my vision which is vertical. I wish that I had done extensive homework before I had my right eye done — but I didn't anticipate trouble, nor did my ophthalmologist. Had I known that I would get a dysphotopsia — I would definitely have requested the temporal position for both eyes. I hope that with some time — maybe up to even a couple of years — that this light streak in your visual field will lessen.

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@tssandy

Has anyone had both eyes done at the same time? Would you recommend it?

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Thank u for the quick reply that was so helpful and also comforting to know that the temporal LPI actually cause less issue for you! I think I will request to have the LPI placed temporally on my right eye. I was very upset knowing that I will most likely have to live with dysphotpsia for the rest of my life and the laser was supposed to help my vision but instead it made it worse.. but after reading ur response and a couple other clinical reports, it seems that the streak of light will become less noticeable over time. And just curious, has ur doctor done temporal LPI on any other patients in the past? Because my doctor mainly does superior LPI, so I don’t know how safe is it for me to have him perform this procedure on me with a method that he doesn’t have much experience with.

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I am possibly needing LPI. My doctor gave a rating to my angle. I could not find a rating system referred to anywhere in my research. Is there one assigned to this condition? Ie., what number would be considered high risk? Also, I have read in British journals that there is some concern cataracts can be caused by the surgery. Has anyone experienced this outcome?

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@kca56

I am possibly needing LPI. My doctor gave a rating to my angle. I could not find a rating system referred to anywhere in my research. Is there one assigned to this condition? Ie., what number would be considered high risk? Also, I have read in British journals that there is some concern cataracts can be caused by the surgery. Has anyone experienced this outcome?

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Check out this article. It speaks of grading of the angle closure.
https://www.reviewofophthalmology.com/article/managing-the-narrow-angle-patient

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@jigglejaws94

Check out this article. It speaks of grading of the angle closure.
https://www.reviewofophthalmology.com/article/managing-the-narrow-angle-patient

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Thank you for this article. (I have been rather busy and apologize for not replying sooner.)
Question for you — are you glad you had the LPI done? Have you experienced any major set-backs or side effects?

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Yes I have that problem presently my Dr. is working on a solution that hasn’t really come up with one yet !

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I am totally freaked out because my specialist is strongly suggesting I need an iridotomy. But after answering my questions today, I find out I have no glaucoma, but he is saying I have narrow angle glaucoma. (Hmm, I am guessing I have narrow angles with no glaucoma). I have no symptoms, no headaches, no problems with my vision, nothing. My pressure is 12/15. No change in the last 6 weeks in pressure. Given that I have no problems now with my eyes, I am pretty understandably apprehensive about getting surgery (which the doctor's office insists is not surgery but rather a "procedure").
Input please. What do you think?

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