YAG laser capsulotomy writeup

[sonia]

About six months after cataract surgery, I had an annual eye exam. I had a similar experience to when the cataracts started seriously affecting my vision, where I wasn't seeing 20/20 through the new glasses I got a few months before. But the cataracts were already fixed!

I remembered that the surgeon had mentioned I might need a laser procedure after the surgery, so I made an appointment with her for the end of October. I figured she would tell me I had to wait since my vision had only changed a little bit so far, but she agreed to do it the week before Thanksgiving. She said the risk was negligible.

I talked to a Portland friend who said, oh that was the procedure that rendered her unable to drive at night because of glare, but her eyes have a lot of ongoing issues.

I went ahead and had the YAG laser capsulotomy in both eyes. The surgeon didn't explain it, but I found online that the laser makes a hole in the capsule around the lens so the light can get through. The process itself was very simple. Get my eyes dilated and numbed, sit at a table and rest my chin and forehead into the machine. She put a thick contact lens on my eye to focus the laser, there were several clicks, and that was it. Did the other eye, and then I was done. She rinsed the goop from the contact lenses out of my eyes, and then a local friend drove me home.

After the procedure, the Portland friend told me she sees big starbursts around lights. I looked up at the light fixture in my bedroom ceiling, and it seemed like I was fine.

However, the next evening I looked up at the unshielded bulbs of the living room lights, and I was seeing big starbursts around them. I went for a walk around the block, and all the streetlights and headlights had them. Uh oh.

I can still ride my bike at night, but the starbursts make it unpleasant. I'm choosing less busy streets, but even side streets can have a parked car shining their bright lights down the block.

At my one week checkup I said I was very concerned about the starbursts, and the surgeon said, "Your eyes look clear - there's nothing I can laser away," and suggested lubricating eye drops and gave me a handful of samples. I'm using them, but they're not making much difference.

I looked it up online, and others have had this issue too. For some, the pupil dilates bigger than the hole in the capsule, which causes the starbursts. That makes a certain amount of sense, and maybe more laser treatment could enlarge the hole, but I'm not sure I want any more procedures at this point, especially if the surgeon didn't know about that.

To make things extra-interesting, my employer is changing my medical insurance at the beginning of the year, so this surgeon will no longer be covered. She said to get in touch in a month if I'm still having trouble. I think I will make an appointment for right at the end of the year for one more consultation.

I feel like I tried to push things too far to fix my eyes. Tried to get rid of one disability and ended up with another one. There's grief and disappointment and fear of limitations. My friend says hers have gotten somewhat better over the years, so maybe mine will too. It's only been a couple weeks, so maybe my eyes are still healing, although I would think it would already be diminishing if it were a short-term issue.

Comments

[threemeninaboat]

If you feel like you need to shrink your pupils a bit for looking at night: Opcon A does a good job of that and is well tolerated if you are not allergic to allergy meds or allergy drops (you are probably not since they put drops in your eyes for the cataract surgeries). It's over the counter and can be used daily. I use it for my patients who have a hard time with accommodative dysfunction.

[sonia]

Thanks, I will give that a try! Seems like a great way to test the theory about pupil size.

Interestingly, I did a quick lookup and it says side effects can be: "dilated pupils, blurred vision; or eyes being more sensitive to light." Does it act differently to contract or dilate the pupils for different people?

[threemeninaboat]

I use it for accommodative spasm and dysfunction in my patients, their pupils are reacting incorrectly and it helps hold the pupil. Dilated and light sensitivity can be more or less related to eye color and med use (it also can make you dry, which also can cause light sensitivity). But it does wear off so it is worth trying.

[sonia]

Thanks for the info!

[radiantfracture]

I'm sorry about the complications. I hope the starbursts go away.

[sonia]

Thank you. From your mouth to the Universe's ear!

[sheafrotherdon]

I do hope the effect lessens with time. Did you have any starbursts in your vision before? I wonder (if not) if you'll acclimate somewhat. I get starbursts at night with my glasses, and while they're definitely not my favorite, you do get used to them / accommodate them.

[sonia]

I did not have starbursts before. I can hope I'll accommodate!

[gingicat]

I'm so sorry to hear that.

I have huge problems with bright lights at night myself.

[sonia]

Thank you, and I'm sorry to hear that!

[thistleingrey]

I've had a similar visual problem since I began driving as a teen (before then, I didn't care much how lights looked at night and don't really remember). No surgery, so far. I wonder whether it's partly how the mind interprets inputs--like, by the odds, we in these comments can't all have the same mechanical issue! :) Hope things become more comfortable for you.

[sonia]

Thanks! And sorry to hear you've had a similar issue.

[runpunkrun]

Your grief and disappointment are understandable. I hope this gets better for you. <3

[sonia]

Thanks for the sympathy and good wishes!

oh, goodness

[jesse_the_k]

your eyes have had a lot of attention in the past few years.

I hope they heal up beautifully.