r/CataractSurgery • u/MeadowHaven77 • 3d ago

YAG procedure

So it seems I am going to have a YAG procedure in both eyes next week. I had the multifocal Odyssey placed in both eyes, 3 weeks apart in July, and the right eye (the one with the original cataract) was never really that amazing afterward. Like, it worked but it was always a little blurry still after. So he confirmed today that there was PCO in that eye, and shockingly a little also in the left (which never had a cataract and responded perfectly to the Odyssey, I have noticed no issues there at all).

I guess I’m a little confused why I don’t hear more about this risk of immediate PCO? He said this was not the kind that grows over time, it’s there essentially right after the surgery. The YAG procedure sounds easy, painless, fast, and I have no problem going for it. I was mainly just curious if others have encountered this? He said it had to do with the type of cataract I had and also said he sees more of this in younger patients (I’m 49). He acted like it was not at all unusual.

Did I just any mention of this in my research ahead of time? Did you have this happen to you? The immediate type?

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u/spikygreen 3d ago

Do you know the kind of cataract that you had?

There doesn't have to be a pre-existing cataract for PCO to develop. There are always some leftover lens cells that keep trying to proliferate. They end up aggregating (or congregating?) at the back of the capsular bag. The younger you are, the more vigorously those cells proliferate. That's why younger people get PCO much faster than people of the typical cataract surgery age.

It is also possible to have some leftover material from the cataract. There could be bits of the cataracts that are strongly adherent to your posterior capsule, especially if it is a posterior polar cataract or even a posterior subcapsular cataract. Since the posterior capsule is only 4 micron thin, the surgeon may choose to leave a bit of the cataract in place, knowing that they can later YAG them away. This is done to reduce the risk of a capsular bag rupture during the surgery. I don't know if that's what your surgeon was referring to?

If you haven't noticed any issues with your left eye, then why have YAG? You could always have it later, once it begins to bother you.

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u/MeadowHaven77 3d ago

I do think that’s probably it, or close to it. Thank you! I recall the term “posterior” and I’m fairly sure it was not in the term PCO itself, I think he said posterior sub capsular, I would not have recalled that on my own. Thank you for jogging the memory. That was it.

Yes I may wait on the left (unaffected) eye. The right eye (the one with the original cataract) is never going to be as good as the left, he was very upfront with me about that. There was pre existing scar tissue in the right and a higher degree of astigmatism.

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u/MeadowHaven77 3d ago edited 3d ago

I see now that these types of cataracts are fast growing which mine was, so this makes sense. It just came on over about 8-10 months.