Fluctuating symptoms can still be due to posterior capsule opacification, but YAG capsulotomy is usually reserved for cases where the overall impact is clearly bothersome.
Possible reasons for fluctuation
Not all variability comes from the capsule.
- Changes in lighting and pupil size altering how haze affects vision
- Dry eye or tear‑film instability temporarily worsening blur
- Glare more noticeable at night or in bright sunlight
- Fatigue making mild PCO more intrusive at the end of the day
- Coexisting issues such as early macular disease or refractive error
When YAG may still be helpful
The decision depends on overall pattern and examination.
- Documented PCO that correlates with your typical “bad days”
- Fluctuations trending worse over time rather than staying mild
- Other causes, especially dry eye, treated or ruled out first
- Understanding that YAG will not fix symptoms unrelated to capsule haze
- Agreement that average visual quality justifies intervention
