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YAG after Cataract Surgery

My Mom had laser cataract surgery 10 months ago. Her vision in her right eye was clear after surgery but 2 weeks later became blurry. The doctor said she developed a PCO and that it was a simple fix with the YAG laser. She had the YAG done yesterday afternoon and her vision is no better, still blurry. The doctor gave her the impression that she would have clear vision in an hour but that is not the case. It has now been 24 hours and she still has blurry vision. I read various things online about how long it would take to clear up. Is it normal to be blurry after 24 hours?
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177275 tn?1511755244
If still blurry in a week needs to be back for. More testing including macular OCT
Helpful - 0
Thank you for responding. Is it normal to take a week for vision to clear? After the YAG my Mom was sent right home. I read that eye pressure should be checked an hour after the procedure but I do not know if this is true. The doctor said her vision would be clear in an hour. Since it has been 30 hours and no improvement I am concerned. I was going to call the Doctor in the morning and see what he says.
By all means call the doctor tomorrow.  Checking IOP an hour after yag laser is no longer standard of practice since the development of special drops that keep IOP down.
I took my Mom back to the doctor today. After almost 3 weeks after Yag her vision is still blurry, no better than before. Her vision was around 20/40 after cataract surgery and it was 20/60 before the Yag and 20/70 after the Yag. He said the cloudiness is gone which I do not understand. The whole purpose of the Yag was so she would see clearly which is not the case. The doctor also mentions today for the forst time the lens has fallen back which is normal and why she is not seeing as well. What was the purpose of going through the Yag laser if it did not accomplish the purpose. The doctor said she would have clear vision in a few hours after the procedure. Now he says to go get glasses. Feeling upset and confused.
Often in a situation like this the best thing is to get a second independent opinion from a different ophthalmologist.    If glasses make the eye see normal 20/20 then get the glasses. If glasses not make the eye see normal then there is some other problem such as macular degeneration or macular edema.    I don't know what "the lens has fallen back means"    Did the doctor say with glasses she see's 20/20? if so get glasses if not get a second opinion.
With glasses he said he could get her to 20/25. This is not really what I am writing about. As far as the lens settling back. He said sometimes the lens may move slightly to the right or left but in my Moms case it settled back a little affecting her seeing in the distance. I just do not understand why a Yag was done for no reason. She had great vision without glasses after the cataract surgery. The Yag was supposed to make her see clearly like she did after the cataract surgery. How do I know if a Yag was even done at all? I am at a loss. Why put someone through this Yag procedure for no reason?
A yag capsulotomy is normally done because the capsule of the eye (not the IOL) is cloudy and is affecting vision.  This occurs in about 30% of all people having cataract surgery. If her vision was 20/40 with glasses after surgery  and 20/60 before the yag but now is 20/25 with glasses after yag surgery then the yag has improved her vision from 20/60 to 20/25.   Remember it is the vision WITH glasses that is important not the vision WITHOUT glasses.    According to your notes she has never seen 20/25 until AFTER Yag capsulotomy.  
Sorry...I guess I was not clear. My Mom never needed glasses. Her vision was perfect after cataract surgery. She was seeing about 20/30 maybe even a little better than that. Three weeks after cataract surgery her vision became very blurry. Now 10 months later the dr said that she was seeing 20/60 and that the Yag would make her vision clear as it was after the surgery. He did the Yag 2 1/2 weeks ago. There was no improvement, still blurry and now testing at 20/70 which was worse than before the Yag. The dr claims the cloudiness is gone which makes no sense since her vision is worse. This is all without glasses. The dr is saying now that the only way to get 20/25 vision is with glasses. So I guess my question is why do Yag? It has made her see just as blurry if not worse. Her vision was perfect after cataract surgery and she was told the Yag would restore it back to good vision but it did nothing.
You mother's vision was not 'perfect' after cataract surgery that would have been 20/20 without glasses. You have posted that she saw 20/40 which you amended later to 20/30 without glasses.   She now sees 20/25 with glasses that is the best since surgery.  also as time passes  after surgery some people have more need for glasses some less.  She obviously is more.  I have stated several times (this is the last) the surgery was done because the capsule of the eye was cloudy.  I'm done making comments. If you have further concerns get a second independent opinion.
Jillie, you missed out that the same cataract surgeon also performed an AK/LRI on your mom, and that she opted not to use Toric lenses (specialty lenses). I do not know how vital is this info, but it might help others with expertise knowledge to help your mom. Kindest regards, Jantje.
She did not want anything "extra". She just wanted her cataract removed with a regular lense. The Dr. Was adamant that the use of the Femto was the only way to get a good result. I had no idea until months later that the Dr. Was not allowed to charge her just for the use of the Femto. He could only charge her if he added a specialty lens or did LRI. I never knew what LRI meant. I initially thought Femto lri was just the name of the machine. She never would have agreed to pay 2800- to get an astigmatism that she did not even know she had fixed in this manner. If she did have an astigmatism why did the dr not offer a specialty lens that could fix it...why? Because she did not want to pay for anything extra. This was underhanded and dishonest.
233488 tn?1310693103
That's why I prepared this piece which I refer people to often:    LINK  https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
Helpful - 0
All I hope is that what my mom went through may be avoided for others by reading what you posted to make an informed decision, an opportunity she was not given. As her caregiver I feel that I let her down. All I was trying to help her with was either to have traditional surgery or laser. I had no idea that a Dr. Would do an LRI with no explanation of what it was just to get paid for using the Femto.
My wife just had cataract surgery a week ago, with a traditional monofocal IOL, that included LRIs for astigmatism with no additional charge(s).
Just curious. Where do you live? Is your wife on Medicare? Was a Femto used?
Dallas-Fort Worth, not on Medicare yet. The facility does have a Femto but I do not know if that was used.
My wife had cataract surgery this year. We did not use femto, did not do LRI,  and chose a modern, aspherical monofocal IOL. The surgery was done by one of my associates. The results were spectacular and the costs out of pocket minimal.  
Dr. Hagan, That is all my Mom wanted, regular traditional cataract surgery that has been done for decades. The 2 doctors my Mom saw are very well known established doctors. They both insisted that because of her dense cataracts surgery would not be sucessful and very risky the traditional way. I only wanted the best outcome for my Mom. In retrospect I am sorry I did not go for a third opinion. My mom was recovering from a stroke and it was difficult to go from doctor to doctor. The worst part is that her vision that was perfect is totally blurry.
Find a different Eye MD cataract/IOL surgeon with a good reputation and training and get a third opinion.   "Well-known" doesn't always mean most honest or most skilled.  We have 'chop shops" in Kansas City where anyone walks in the doors is leaned on for surgery and once surgery is scheduled  the entire office tries to 'up-charge" with options like femtosecond laser, ORA technology, multifocal IOLs.  I have been doing this blog since 2007 and that is a message I have constantly preached.
You are right Doctor Hagan. I have learned alot. It does not help my Mother but I am hopeful it will help someone else make an informed opinion. The Doctors I took my Mom to were highly recommended by a hospital. It was even suggested to ask the operating facility nurses because they see everything and I did that. These are 2 doctors in NY that have excellent reputations.
Not possible to 'undo'.  If she has acceptable/good vision with glasses that would still be considered a good result.  Hopefully she will do well with glasses.
One thing I really did like about the surgical facility I was referred to was that, although they offer premium IOLs, astigmatism management, etc. there was no pressure to upgrade after I told the surgeon on my initial visit that I was intending to address only my left eye that needed the surgery now, and that I was comfortable wearing corrective lenses (RGP contacts in my case) afterward like I've done for decades. Both he and my optometrist said that although it was relatively unusual for someone to  not have both eyes treated for cataracts at the same time, neither in any way pushed for it.  
Just to take this a step further some practices, including Kansas City,  rush the second eye, want it done a week after the first. I think this is bad practice.  Our group does not operate on second eye until first eye healed and patient happy. Then we ask about uncorrected vision on second eye, "without glasses would you like your second eye to have better distance or near vision"?  You can't do that one week apart.  
That is an excellent point. My Moms doctor did her eyes 2 weeks apart. He  stressed it would be easier to do it close together so that she would not have to go to the doctor again for medical clearance. He said most people after having the first eye done are so happy they cannot wait to do the second eye. I think waiting would have been a good idea. We really had no understanding of lenses, distance or near. My mom mainly wanted to see to watch TV. He said he would set one lense for distance and one for middle vision which he said she would be able to see far and near. It sounded reasonable and that is what was done.
Not much more I can add.
Dr Hagan..I just wanted to tell you that I got my Mothers records from the first doctor I took her to and there was NO astigmatism.  I am sure you are aware that a doctor cannot charge a Medicare patient for the Femto unless the patient is getting a specialty lens or lri procedure. If a doctor chooses to use the Femto method they cannot charge the patient extra. My mom did not want anything extra. She got regular lenses. It seems the only way the doctor could charge her 2800- extra was to write lri on the ABN.
You have options as I outlined before: you can report the surgeon to Medicare,  the tie-in insurance,  the local medical society if surgeon member, the American Academy of ophthalmology if member, the state insurance commission.    
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177275 tn?1511755244
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