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Treatment — Laser vitreolysis

Treatment — Laser vitreolysis

What is laser vitreolysis?

The laser vitreolysis, which is also known as floater laser, is a minimally invasive and painless treatment to remove floaters from the vitreous body. It will enable you to pursue your daily routine without any disturbing visual impairments.

    How does laser vitreolysis work?

    During the laser vitreolysis, the vitreous body is accurately irradiated with extremely short (0.000000003 seconds) laser light pulses. The floaters absorb this laser energy, which reduces their size and eventually dissolves them. Disruptive tissue strands are severed. The solid floater tissue can be reduced considerably and will no longer impair your field of view by opacities.

    What happens during the treatment?

    The laser vitreolysis is done as an outpatient surgery which means an overnight hospital stay is not necessary. Before the treatment, eye drops will be administered to your eye for light local anaesthesia. The laser light is sent into your eye from the laser source in a special microscope through a contact laser lens.

    It is possible that you perceive little dark spots or shadows during the treatment, which means the floater is dissolving. This can cause tiny gas bubbles, which will, however, disappear rather quickly as they are incorporated in your vitreous body. At the end of the treatment, your ophthalmologist may or may not administer antiphlogistic eye drops.

    A laser treatment takes about 20-60 minutes. The number of necessary treatments depends on how many floaters there are in your eye and on how severe your visual impairment is. Most patients require two to three treatments.

    After the treatment

    It is possible that you perceive little dark spots in your lower field of view. There is no need to worry though, as they will dissolve quickly. Some patients experience minor discomforts immediately after the treatment, such as redness of the eye or a temporarily blurred vision.

    Complications and side effects

    Only very few complications and side effects have been reported, but in some cases the treatment can cause cataracts or an increase of the intraocular pressure.

    Who benefits most from the laser vitreolysis?

    It is very important that you have your eyes checked thoroughly to determine whether you are an eligible patient for the floater laser treatment.

    • Age: Most commonly, younger patients (< 45 years) have microscopically small floaters near the retina (with a distance of 1-2 mm). The treatment by means of floater laser is usually not suitable for this group of patients
    • Development of symptoms: A posterior vitreal detachment may be associated with floaters that develop rather rapidly. In these cases, the laser vitreolysis can be applied.
    • Floaters‘ characteristics: Large floaters with smooth edges and a certain distance to the retina are best suited for laser vitreolysis treatment.

    Literature

    Specialised literature:

    • Sebag J, (2011), Floaters and the Quality of Life. Am J Ophthalmol 152: 1-4
    • Windt C, YAG Laser Vitreolysis for the treatment of floaters, Whitepaper (PDF, 260 KB )
    • Mirshahi A, Hoehn F, Lorenz K, Hattenbach LO, Incidence of posterior vitreous detachment after cataract surgery. J Cataract Refract Surg. 2009;35:987–991
    • Schiff WM, Chang S, Mandava N, Barile GR, Pars plana vitrectomy for persistent, visually significant vitreous opacities. Retina. 2000;20(6):591-6
    • Sendrowski DP, Bronstein MA. Current treatment for vitreous floaters. Optometry. 2010 Mar;81(3):157-61.
    • Delaney YM, Oyinloye A, Benjamin L,. Nd:YAG vitreolysis and pars plana vitrectomy: surgical treatment for vitreous floaters. Eye (2002) 16, 21–26.
    • Tsai WF, Chen YC, Su CY. Treatment of vitreous floaters with neodymium YAG laser. Br J Ophthalmol 1993; 77: 485–488.
    • Toczolowski J, Katski W. Use of Nd:YAG laser in treatment of vitreous floaters. Klinika Oczna 1998; 100: 155–157
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