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Developed posterior capsular opacification less than 2 weeks after cataract surgery?

I'm a 41 year old female, and I'm a software engineer. I had cataract surgery for my left eye on Nov.6, and the right eye a week later. I was very happy about the vision for the left eye initially. However, I started to notice a film coming over my left eye after about 10 days post-op. It comes and goes and is usually more noticeable under dim light. I told the optometrist in my 1-week post op visit for the right eye which was also 2-week post-op for the left eye. He insisted that it was caused by dry eye, and he also told me that he noticed some cells growing in the back of the IOL. I did not get to see the surgeon on that visit, and the optometrist just told me to continue the original schedule of eye drops, even though I'm starting to cut down the steroid drops according to that schedule.

I visited the office again yesterday, and it was more than 4 weeks post-op for the left eye, and I had completely stopped all the drops except the artificial tears. The surgeon told me that I had posterior capsular fibrosis right behind the pupil for the left eye, and only trace amount for the right eye. He said the film sensation was caused by the PCO, and it comes and goes because of pupil size change, which made a lot of sense to me. He said the left eye fibrosis was a 3+, whatever that was. He told me to start Acular and Pred Forte 4 times a day for the left eye, and visit again in 2 months. As for the right eye, he said I can start Acular and Pred Forte if I notice similar symptoms. He basically left that decision to me.

My questions is --
1. Are the drops going to reverse the PCO on the left eye, or only stop it from getting worse?
2. What should I do for the right eye? It's my good eye now, should I use Acular and Pred Forte 2 times a day just to prevent PCO, given what happened to the left eye?
3. If the doctor decides I need a YAG in 2 months, will the YAG completely restored the clear vision I had on the left eye for a short while after the surgery? Or will it only marginally improve the vision considering my early and rapid development of PCO?

Thank you for any help or advice you can give!
14 Responses
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177275 tn?1511755244
Often especially if there is a posterior capsular cataract or a posterior polar cataract or an inflammatory cataract the posterior capsule is found to be cloudy at the time of surgery and cannot be polished clean. Then the usual procedure is finish the operation, use anti-inflammatory drops and let the eye heal as yours was. Then several months later do the Yag. So its likely that the capsule was already cloudy and did not turn cloudy immediately after surgery.

JCH MD
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Avatar universal
The same exact thing happened to my right eye after cataract surgery, and my Ophthalmologist also said that he wanted to wait for three months so that my eye would heal before using the YAG laser...the vision in my left eye is almost 20/15 and, I had the same exact surgery with exactly the same implant. I find it strange that I had such different outcomes in both eyes...good luck, and I'm sure that everything will be fine.
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711220 tn?1251891127
MEDICAL PROFESSIONAL
I doubt Acular and Pred Forte will help with the PCO.

Dr. O.
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Avatar universal
Dr. O.,

Thanks for the comment.

The YAG laser must have had a tremendous impact on the outcomes of cataract suirgery.

Don W.

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Avatar universal
Thank you, Dr. O. I hope my doctor has a good reason for the 12 week rule, and the reimbursement rate is not the only reason.

Do you think I should do Acular and Pred Forte 4 times a day for the next 2 months since it most likely won't do any good? What would you recommend as far as the eye drops are concerned?

Thank you for your help!
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Avatar universal
Right then.  No way was it going to get better on its own, after all.
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711220 tn?1251891127
MEDICAL PROFESSIONAL
The laser is focused at the PC which is far from the retina. A yag can be done sooner than 12 weeks.  The post operative period for a cataract surgery and a yag done during that period is reimbursed at a lower rate.



Dr. O.
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Avatar universal
Did you have the YAG right away? Or did you wait a while?
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Avatar universal
Dr. O  or ...

Peripheral question.

What prevents the YAG laser from damaging the retina during this PCOelimination  process?

Don W.

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Avatar universal
As I recall, it was about 6 weeks.
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Avatar universal
Thank you Dr. Oyakaqa for your quick response.
My surgeon said he does not do YAG within 12 weeks of surgery. Is that because the risk is higher if YAG is done too soon after the surgery?
Is 3+ fibrosis considered very bad? Should I be concerned that PCO developed so early and so fast in the left eye? Can the fibrosis get worse?
Thank you for your help!
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Avatar universal
Thank you, Achillea. That's very encouraging! How long after the surgery did you develop PCO?
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711220 tn?1251891127
MEDICAL PROFESSIONAL
1) No.  2) Doubt the drops will do much 3) Yes, but why wait so long?

Dr. O.
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Avatar universal
I also developed PCO in one eye fairly quickly after cataract surgery and IOL implantation (but well after I had completed the steroid drops).  My surgeon simply recommended the laser procedure, which instantly and painlessly restored the sharpness of my vision.  That was almost three years ago, and the problem has not recurred.

Your situation appears to be a little different, but I can affirm that the laser procedure can be wonderfully successful for PCO.
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177275 tn?1511755244
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