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. 2022 Aug;70(8):3026-3032.
doi: 10.4103/ijo.IJO_3198_21.

The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment

Wan Ni Goh  1 , Mushawiahti Mustapha  1 , Syed Z S Zakaria  2 , Mae-Lynn C Bastion  1
Affiliations

The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment

Wan Ni Goh et al. Indian J Ophthalmol. 2022 Aug.

Abstract

Purpose: To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD).

Materials: This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis.

Results: Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = -3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = -2.788, P = 0.005), and mental health (z = -2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments.

Conclusion: Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.

Keywords: Contrast sensitivity function; floaters; laser vitreolysis; neodymiun-doped yttrium aluminum garnet laser; posterior vitreous detachment.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Consort flow diagram
Figure 2
Figure 2
Fundus photography before and after laser vitreolysis. (Left) Black arrow shows a single small clump floater in front of the optic disc; (Right) White arrow shows minimal remnant of vitreous opacity left after vitreolysis. Patient was asymptomatic after one session of laser so no further treatment was given
See this image and copyright information in PMC

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