YAG Laser vitreolysis for eye floaters
What is YAG laser vitreolysis?
YAG laser vitreolysis, also known as floater laser removal, is a non-invasive, out-patient based procedure which uses laser to vaporize the vitreous opacities which are causing the eye floaters.
What are eye floaters?
Eye floaters look like small dots, lines, thread-like strands, clouds or cobwebs in the field of vision. They may seem to be in front of the eye, but they are actually clumps of vitreous gel inside the eye. What happens is that when the light enters into the eye, it passes through the vitreous and these clumps of vitreous gel cast shadows in the retina, which is then perceived as eye floaters.
Treatment for eye floaters
Eye Floaters due to aging or posterior vitreous detachment from the back of the eye may not need any intervention. Some may require treatment if it is caused by any other eye condition or if the floaters are causing a significant effect in the vision.
Eye Floaters due to white blood cells in the vitreous caused by an infection or inflammation can be treated with the appropriate antibiotics or anti-inflammatory medications. Floaters due to bleeding that may be caused by trauma, a retinal tear or as a result of diabetic retinopathy usually resolves as the blood is absorbed, but further investigation and treatment should be done to ensure that the bleeding stops.
Pars Plana Vitrectomy or the surgical removal of the vitreous can also be done for some cases, but since it’s an invasive procedure, it is not usually done on common types of floaters as there is a significant risk of bleeding, infection, retinal detachment and development of cataract. Another option is through YAG laser vitreolysis.
YAG Laser Vitreolysis
YAG Laser Vitreolysis uses a nano-pulsed YAG laser to vaporize the vitreous opacities. Vitreolysis may not be widely practiced but has been proven to be effective and safe by its pioneers back in the 80s. Following the clinical studies, vitreolysis was found to be effective with high patient satisfaction response.
Laser surgery for floaters is less invasive and safer than vitrectomy, but the technical limitations in conventional YAG lasers pose a significant risk in damaging the eye tissues, making it a less popular treatment option.
One published study reported that 53% of its subjects who underwent laser vitreolysis reported significant improvement in symptoms compared to 9% in the placebo group. Photographs also showed significantly improved or resolved floaters in 94% of its subjects.
Eye drops are instilled on the eye to dilate the pupil.
Anesthetic eye drops are given to numb the eye.
A special lens for treating floaters is placed on the eye.
The laser is then carefully aimed by the physician on the floater or its attachment.
There are no restrictions after the treatment. Normal activities may be resumed after the procedure.
Who’s a good candidate for vitreolysis?
Patients with Weiss-ring type of floater are the ideal candidate for vitreolysis since these floaters are fibrous, which means they can absorb laser energy well and be vaporized more efficiently. They are also located away from the lens and retina. Other types may be treated as well but the impact on vision may depend on the type of floater.
Potential Risks and Side Effects of Vitreolysis
Elevated eye pressure
Swelling of the retinal nerve fiber layer
Damage to retinal nerve cells
Residual floaters post-treatment
Recurrence of floaters