POSTERIOR SEGMENT VITREOUS FLOATERS
YAG Laser Vitreolysis Improves
Symptomatic Vitreous Floaters
“The doctor said I had some little floaters in my eyes . . .”
by Collins Santhanasamy
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isual floaters – described by their symptoms of tiny specks, circles and shadows that appear in a patient’s field of vision – become increasingly prevalent with age due to the degenerative vitreous changes that occur throughout life. In youth, hyaluronan ensures that the collagen fibrils remain separated in the vitreous cavity, maintaining the transparency of the vitreous. However, with time, this hyaluronic acid dissociates from collagen, causing cross-linking and aggregation of collagen with fibrous structures that scatter light—a process known as vitreous liquefaction. Clinically, a posterior vitreous detachment (PVD) is often marked by
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a degree of fibroglial tissue known as a Weiss ring that is free floating over the optic nerve. A PVD allows the vitreous body to move when the head or eye moves, and thus, the Weiss ring and vitreous opacities cast shadows onto the retina that are perceived as floaters. A PVD is present in approximately 65% of patients reaching the age of 65 years. Although most patients grow accustomed to the visual disturbance associated with Weiss rings and other floaters, many patients find them bothersome due to various factors including a reduction in contrast sensitivity which affects their quality of life.
Three management options currently exist for patients presenting with symptomatic floaters: •
For patients who find that the floaters are not really impacting their quality of life, a Non-Invasive “learning to live with floaters” management plan focusing on patient education and observation may be the best option.
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The second option for symptomatic patients would be a surgical option known as a pars plana vitrectomy (PPV) with either a 1-incision intrector or a standard 3-port vitrector.
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The third option currently available for patients is laser vitreolysis, also referred to as Laser Floater Removal (LFR) or YAG vitreolysis.