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How does YAG laser for PCO affect a mild epiretinal mebrane?

I have had a mild epiretinal membrane for about a year now which does not affect my vision at all.  The doctors have told me that there has not been any significant change over the past year.  My surgeon told me on my last checkup that he sees a small amount of PCO in my right eye (the same eye that has the ERM). My vision in that eye seems perfectly clear to me and he does not recommend I do the YAG at this time.   How fast does PCO progress?  Is it possible for it to never progress?  If it does get worse,  how will this effect the ERM?  Will it make it worse?  I would love any information that anyone has had with a similar situation.  Thanks in advance.
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177275 tn?1511755244
PCO = posterior capsular opacity.   This occurs after cataract surgery due that membrane forms the new lens fibers in the normal lens. Once the lens is removed we don't want new lens fibers as they cause PCO.  So surgeons scrape and polish the posterior capsule and IOL manufacturers have modified IOL edges to prevent lens fibers from growing over PC and turning cloudy.  Prior to about 2001  more than 90% of people got significant PCO and needed yag capsulotomy.  After 2001 due to improvement just mentioned the % is 15-20%    I did two Yag capsulotomies in the morning clinic.     No way to predict how fast they will grown,  some don't progress,   ERM= epiretinal membrane not effect PCO but whatever reduced or distorted vision is due to ERM will not be helped by Yag laser.
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Thank you for responding.  I know that ERM has no effect on PCO.  I was wondering if YAG (if PCO gets worse and needs to be done) will aggravate or make the ERM worse.
Rare, yes it does cause problems.   1. The vitreous can move forward after Yag and elevate and distort the ERM  2. Fluid (macular edema) can develop under the ERM       Discuss with your surgeon.  Some surgeons try and make Yag opening small to try and keep vitreous from shifting  2. some pretreat with ketorlac/nevanac/illevro  
Thank you for responding.  You wrote rare, yes.  Is it rare and yes it can make things worse but not most of the time?  What do those medications that you can pretreat with do.  How do they help?
They are a type of non-steroidal anti-inflammatory and they are widely used before and after cataract and other type of intraocular surgery to prevent the macular edema (swelling).     Not large studies to quote but probably 96% of the time Yag will not make ERM bigger,  risk of macular edema post Yag maybe 5%.
Ok.  Thanks again for your response.  I am not up to the point yet of needing it but since the surgeon noticed the beginnings of PCO on the inner side of my eye I was worried.  I would have never noticed the PCO or the ERM.  It all seems clear to me.
If things see clear you don't need to do anything to either. It's like a cataract. If it doesn't bother you leave it alone.
Thanks.  I am leaving it for now but I worry how fast it can get worse and it seems like it is inevitable.
I've had patients (including several I saw today) that have had PCO for years on end without getting bad enough to have surgery.
Thanks. That’s good to hear.  I hope that will be my case for the PCO and the ERM.  I’m not sure which one is worse.
To me, the ERM is worse but only because of it's potential visual impact and the treatment being more complex. I have one along with a minor cataract in my RE and so far have no need to address either.
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177275 tn?1511755244
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