How YAG laser vitreolysis can be used in practice for treatment of floaters
Inder Paul Singh, MD, shares his surgical pearls for how advances in YAG laser vitreolysis can make the procedure a safe, effective option for the treatment of floaters.
Take-home: Inder Paul Singh, MD, shares his surgical pearls for how advances in YAG laser vitreolysis can make the procedure a safe, effective option for the treatment of floaters.
By Inder Paul Singh, MD, Special to Ophthalmology Times
Until recently, patients suffering from bothersome
Given that the latter option can be a highly invasive procedure often associated with complications-including infection,
In contrast, vitreolysis-which involves the use of a specially designed YAG laser to vaporize the vitreous strands and opacities-has shown to be highly effective in providing functional improvement with a low complication rate.2
In a study by Cees van der Windt, MD, and colleagues, 100 eyes with posterior vitreous detachment-related floaters persisting for more than 9 months were treated with vitreolysis (n = 65) or pars plana vitrectomy (n = 35). Findings showed that both the YAG and vitrectomy groups reported an improvement in vision at 80% and 90%, respectively.
Additionally, over the 8-year follow-up period, no complications occurred among patients in the vitreolysis treatment arm. Moreover, data from two studies carried out in 1990, demonstrated a near-100% rate of floater removal with vitreolysis. No intra- or postoperative complications occurred in any patient.3, 4
Although vitreolysis is a much safer procedure than vitrectomy, medical schools generally do not teach it. Also, because of some problems associated with traditional YAG lasers, some ophthalmologists may be a little reluctant to offer the procedure to their patients. Though initially a little skeptical about vitreolysis, after incorporating multimodality YAG laser technology (Ultra Q Reflex, Ellex Medical Lasers) into daily practice, I have revised my opinion.
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