Still cloudy vision at night after yag

[Mark99999]

I am a 46 years old male and I have RP. I have had cataract surgery in left eye in June 2012. From day one I had cloudy vision after surgery, which progressively got worse. In November I had a YAG and now I can see good in normal day light but I get glare, at night or indoors under flurescent light my vision goes cloudy just like before I had the YAG. When I look at street lights I see a hazy halo around the light. I have been to see my optician who was surprised to be able to see the outer edges of the capsule through my pupil using the slit machine without even having to dilate my eye. When I saw the consultant who did the surgery he dilated my eye and gave a thorough examination but said every thing was good, the posterior of the capsule was still a bit jagged, he said what the optician saw was the front edges of the capsule. He did not want to do a second YAG to make the opening bigger. He gave me some drops to see if the cloudy ness would go by reducing the size of the pupil. The drops did help a little but made things dark. Do you think I need a 2nd YAG. The dark evenings and indoors are becoming unbearable as I can see better through my eye with the cataract than the operated eye at night. I would be grateful for any advice and wether you think Yag is the only answer.

[Mark99999]

Thank you for your informative reply. I will make an another appointment with my consultant to get the opening made bigger. I wish my doctor had explained everything as clear and concise as you, I can see you understand the symptoms of RP. My consultants said he had done hundreds of cataract surgeries on RP patients but I feel he does not understand. I thank you again and I will let you know the outcome.
Regards Mark

[Timothy D McGarity, M.D.]

Eyes with RP that have undergone cataract surgery have a much higher incidence of developing cloudy posterior capsule, but also have a higher chance of developing a condition known as Progressive Capsular Phimosis. This can lead to a progressive band-like contraction of the anterior capsular opening. The yag laser can be used successfully on the anterior capsular opening to make radial cuts thus relieving this contracting band. Furthermore, regarding your posterior capsular opening, it does sound like you need to have the opening enlarged. I think the benefits outweigh the risks and you need all the light you can get b/c of RP...get the yag touchup on the posterior opening and possibly on the anterior band contraction and avoid the alphagan (brimonidine) drops if possible.
Sincerely,
Timothy D. McGarity, M.D.
www.tmcgaritymd.com