Article
YAG vitreolysis highly effective for disturbing vitreous floaters, results of a prospective case series of 162 eyes in Amsterdam, the Netherlands (P1)
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Authors
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Feike Gerbrandy
- Amsterdam Eye Hospital Opsis, Amsterdam, Netherlands
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Ingrid Birker
- Amsterdam Eye Hospital Opsis, Amsterdam, Netherlands
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Jaap Dito
- Amsterdam Eye Hospital Opsis, Amsterdam, Netherlands
| Published: | October 18, 2013 |
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Outline
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Purpose: To assess the safety, effictivity and patient satisfaction of YAG vitreolysis (floaterlaser) for disturbing vitreous floaters.
Methods: A prospective clinical case series. Included were: all patients with treatable floaters and a floater score (FS) of 5 or higher. FS is a score of subjective symptoms on a scale from 1 to 10. Microfloaters and floaters too close to lens or retina were considered not treatable by laser and were excluded. All eyes were treated by the same surgeon. At the end of follow up patients were asked to fill out a questionaire. A total of 162 eyes of 123 patients were included.
Results: Average FS was 7.57 before treatment and 3.89 after treatment. 85.9% of patients was satisfied with the result. 14.1% was not satisfied. On average 2.07 treatment sessions were needed. Average follow up was 370 days (range 6-18 months). 93.3% would recommend this treatment to other people. This included 47% of dissatisfied patients.
Complications: 1 retinal detachment (0,62%), no cases of damage to lens or retina, 3 cases of mild elevated eye pressure. Several videos of vitreolysis will be shown in this presentation.
Conclusions: YAG vitreolysis is a safe treatment for most disturbing vitreous floaters with a nearly incredible high patient satisfaction. The patient satisfaction rate of this study is comparable to published results of vitrectomy for floaters (88,4%). However vitrectomy has a higher complication rate. Recently reported rates of retinal detachment after vitrectomy for floaters range from 2.5% to 10.9%, rates of severe visual impairment range from 0,86% to 5,6%. In our study these rates were 0,62% and 0% respectively.
Many patients are severely disturbed by their vitreous floaters. They prefer a treatment that is safe and easy to undergo. Floaterlaser is an ideal candidate as treatment of first choice because of its high effectivity, low complication rate and quick recovery time. A vitrectomy can be considered in case laser is not possible or fails to resolve the symptoms.
There are only 2 usable published reports about YAG vitreolysis. Tsai (1993) reported 100% succes in 15 eyes. Delaney (2002) reported improvement in only 38.3% of 38 eyes. The difference can be explained by the laser settings used.
