Efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for vitreous floaters

Abstract

Objective: To examine the efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for the treatment of vitreous floaters.

Methods: Consecutive adult patients with symptomatic vitreous floaters who attended Chongqing General Hospital from April to December 2016 were included in this prospective study. Patients had >3 mm between the vitreous opacity and retina/lens and acceptable quality peri-papillary Optical Coherence Tomography (OCT) images (i.e., signal strength ≥5). Those with history of glaucoma, severe cataracts, vitreous haemorrhages, retinal holes and/or macular disease were excluded from the study. Best corrected visual acuity (BCVA) and non-contact intraocular pressure (IOP) were measured before and for up to 6 months post-YAG laser vitreolysis. Anterior segment photography and peripapillary retinal nerve fibre layer (RNFL) measured by OCT were taken before and 6 months post-procedure. Questionnaires on patient satisfaction were completed 6 months post-procedure.

Results: No statistically significant differences in BCVA and IOP were observed before or after treatment. Anterior segment photography showed that vitreous opacities partially or completely disappeared after YAG laser treatment. The thickness of RNFL in four directions (upper, below, nasal and temporal) was not statistically significant different before or 6 months after the procedure. 75% patients reported significant improvement and 25% reported moderate improvement.

Conclusion: The results of this study conducted in a cohort of 30 Chinese patients showed that YAG laser vitreolysis was a well-tolerated and effective treatment for vitreous floaters. Randomised, controlled trials involving large numbers of participants monitored over an extended follow up period are required to confirm these results.

Keywords: Yttrium-aluminium Garnet laser vitreolysis; anterior segment photography; optical coherence tomography; peripapillary retinal nerve fibre layer; vitreous floaters.

Figure 1.

Anterior segment photography with the aid of a Volk Digital High Mag optic lens before and 6 months after YAG laser treatment. Pre-operative: An irregular ribbon-like opacity in optic axis of vitreous cavity was observed before treatment. Post-operative: Six months after YAG laser treatment the ribbon had disappeared and some cloudy segments remained.