Question: Hi, I have a question for an ophthalmic surgeon. I had a YAG laser capsulotomy yesterday and everything went well; however, I have several string like floaters now since the surgery. The doctor did say I would probably notice some pieces of the capsule which would look like floaters. Will these go away (disintegrate or get absorbed) or are they just like vitreous floaters that never go away? If they do go away about how many weeks does it normally take. Thanks for any help - I couldn't find much about this on the web.

I am using Pred Forte drops 4x per day for 4 days as prescribed. Is this to help dissolve the capsule fragments? I thought it was to avoid inflammation. I have noticed that even just since yesterday several of the smaller floaters are gone, but I do have one larger piece of capsule that I am concerned about. I don't mind if it takes several weeks as long as I can put my mind at ease that it will be gone eventually and is not permanent.

Dear Dr. Misra,
Thank you for the above response - you were 100% correct - all pieces of the capsule are gone. I was having a problem that I thought was due to light scattering off the floating pieces of capsule, but the problem did not resolve as the pieces subsided. I will briefly summarize my situation and the resulting problem. I am a 49 year old female and had cataract surgery 12/4/12 on my left eye. A monofocal technis IOL was inserted. Everything went well but after 2.5 weeks I developed a streak when looking at point light sources due to a wrinkle in the capsule. I had the YAG procedure done on 5/3. The streak is definitely gone but I have TERRIBLE star bursting especially at night. It is really bad and if I could go back to having just the streak I would. I happened to notice it wasn't nearly as bad in brighter lighting when my pupil was small and thought maybe the hole in my capsule just needed to be made a little larger. I tried Alphagan P eye drops which eliminated the starbursts for a short period (about 1/2 hour.) Yesterday I saw the ophthalmologist who did my surgery and he says the capsule hole is large enough. He seemed really dismayed as to what could be causing the starbursts. He said he could YAG the capsule a bit more to see if this helps but first has started me on 1% pilocarpine eye drops and says my brain hopefully will adapt. The pilocarpine totally eliminates all the starbursting! I am overjoyed but would prefer not to have to use pilocarpine for the next 30 years. Could the problem be due to light scattering off the edges of the newly created capsular hole - do you think enlarging it would alleviate the problem? Have you ever seen this at all in any of your patients and, if so, how did you resolve it? Thank you for your time, I REALLY appreciate any help.

Hi, thanks. I had a complete exam by a retinal specialist right before my YAG and he said everything looked great. Wouldn't this area have to have been weak before the YAG for the energy to affect it that much? Also, if it were peripheral degeneration of the retina wouldn't I be seeing flashes of light in the peripheral region of my vision? This is not what I am seeing. I am seeing straight thin long lines of light which pass directly through the point-source in all different directions.

If it is peripheral retina degeneration, does that get better on its own? I would think I would want to see a retinal specialist right away.

I know the pilocarpine is not going to help the problem, but by constricting the pupil it eliminates the starburst in my vision. Will it do any harm to keep taking it?

Thank you for getting back to me. Yes, I too think the retina is fine but will have it checked out to be safe. Just wondering if you have any other idea about why I am seeing what I am seeing (star bursting thin long lines of light through point sources). If you don't have any ideas, that's alright. Thanks.