Cataracts Treatment

Question by ah well: Anyone have any idea why I lost some vision after YAG surgery?
I’ve always had 20/20 vision until I got cataracts and I’m just 39 (too young for cataracts). Then it was 20/50 when the doctor operated and I got back my 20/20 vision. I had it for at least a month after the cataract was removed but because some membrane blurring over I had to have something called “Yag” laser treatment where it seems they pretty much burn a hole in the membrane to let light in. Not long after I was 20/30. Why would I lose my long distance vision after? I was told it was safe and would “completely take care of the problem”.

Best answer:

Answer by Paul MB
The lens is formed from outer skin cells as the embryo is developing. The basement membrane of the skin becomes the outer part of the lens as the cells infold, forming a sphere inside the neurologically derived optic cup. This basement membrane forms a capsule around the lens. When cataract surgery is performed, the front of the capsule is opened. Then the inside stuff, the cortex and nucleus of the lens itself is removed by phaco ultrasound or aspiration. What is left is this little empty sac. The ‘new’ lens is placed inside this capsular bag. But not ALL the lens cells are removed and some may continue to grow and eventually form an opacification along the back of the lens capsule causing light to be interfered with as it passes through the lens. It’s sort of like having a dirty windshield then going west at sunset or having night oncoming headlights hit the windshield. It can cause so much glare one can’t see out of the windshield.

The method we used to use to open this foggy membrane was to insert a needle behind the lens, push some fluid into the little space so the capsule moved back a bit, then using the tip of the needle, catching the membrane and tearing it open. Now days we use a YAG laser. The Yag laser uses two beams of laser light that cross at a certain distance. Where they cross, the energy sums and causes an immediate increase in the temperature at that point to about 900 degrees F. This causes a small vaporization of the fluid or water or a mini-explosion. It tears the capsule. if the laser hits the lens it can cause “pitting”. If the lens capsule is opened too ’soon’ after surgery, the plastic lens can shift backwards or forwards a little which might change the focal length and cause blurr. The capsule or debris can also reform and form another membrane with the anterior vitreous face. This too can be YAG’d. Yes you can have other problems too such as traction on the vitreous which causes a retinal tear. The laser can hit the iris and cause inflammation causing a secondary iritis and cystoid macular edema…this is rare but not really all that rare.

So… my suggestion is you go back to the doc and see if you’ve a change in refraction which would indicate a lens shift, or see a retina specialist if the general ophthalmologist can’t figure it out. There IS a reason for this, one just needs to study the eye, possibly do some ancillary tests such as fluorescein angiography or Ocular Coherent Tomography which would show the edema, if present.

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Question by Bob: Any idea on how much it costs to have your dog’s cataracts removed? Are there any other treatments available?

That is why I bought a dog from a breeder who does CERF, and hips. My pup with the cataract is a 5 year old puppy mill rescue, and yes, she will have the surgery. I’m just trying to get an idea of cost. Thanks.

Best answer:

Answer by tom l
Now you know why we have the eyes checked and certified on the dogs we breed.

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