Can PCO occur immediately after cataract surgery?

[curio255]

Some sources say that it takes a while for PCO to occur, but some patients state that vision after cataract surgery was never clear until after YAG surgery.

[curio255]

Hi Doctor. Yes, I did have a PSC that was present for some months before removal, so maybe my continued cloudiness/blurriness is now due to PCO. I have two more questions:

1) Is it more likely that I have PCO at only 3 weeks post cataract surgery  or that I have an improper IOL script?

2) How does YAG capsulotomy cause CME and what can I do to reduce the chances of getting CME from YAG?

As always, I appreciate your responses.

[John C Hagan III, MD, FACS, FAAO]

We have discussed this before. There are certain types of cataracts that cause the posterior capsule to cloud up while that type of  cataract is forming.  The most common type would be a longstanding posterior subcapsular cataract. So when the surgery is done and the cataract is removed, the capsule is clouding. I have noted this in the past during surgery. What I tell the patient is that we took the cataract out but the cataract caused the posterior capsule to be cloudy and we will need to do a yag  capsulotomy  soon. usually I waited 4-5 weeks to let the eye recover from the cataract surgery and to reduce the risk of cystoid macular edema after the yag cap. so it does happen but relatively unusual

[curio255]

Hi Doctor. Yes, I did have a PSC that was present for some months before removal, so maybe my continued cloudiness/blurriness is now due to PCO. I have two more questions:

1) Is it more likely that I have PCO at only 3 weeks post cataract surgery  or that I have an improper IOL script?

2) How does YAG capsulotomy cause CME and what can I do to reduce the chances of getting CME from YAG?

As always, I appreciate your responses.

[John C Hagan III, MD, FACS, FAAO]

1. If you had an IOL power that was more than a diopter off the planned target you would still be able to see 20/20 when the proper glasses were put over the eye (assuming the rest of the eye is normal). With PCO the vision does not improve with glasses and the surgeon can see the cloudy posterior capsule like seeing dirt on a windown
2 CME used to be extremely common. the mechanism is due to inflamation and increased vascular permeability.  Now drugs similiar to NSAIDS are used pre/post operatively e.g. ketorolac. My personal opinion and practice was to wait a while for the eye to heal from cataract surgery before doing yag and to continue the anti-inflammatory drops longer than usual

[curio255]

Thank you for the details Doctor. Much appreciated.

[John C Hagan III, MD, FACS, FAAO]

You are welcome