July 25, 2018 | POSTED BY | Clinical Optometry, Posterior Segment
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New Treatment Options for Vitreous Floaters

For chronic sufferers of large floaters, new technologies offer innovative treatment options that are safer and less invasive than traditional methods.

For many years, the standard of care for treatment of vitreous floaters was a pars plana vitrectomy, an invasive surgical procedure that removes part of the vitreous. Post-vitrectomy recovery times vary from patient to patient, but stabilized vision and bruise reduction can take anywhere from four to six weeks. Moreover, post-surgery outcomes leave the patient with poor vision that can take several weeks to resolve while putting the patient at risk for potential complications like traumatic cataracts, retinal detachments, endophthalmitis, ocular hypertension, cystoid macular edema, and additional vitreous hemorrhages. 

With the introduction of YAG laser procedures, many physicians are now using laser to blast apart dense vitreous floaters in a process called laser vitreolysis. For many, laser vitreolysis provides an alternative other than surgery to remove or break up pesky floaters. Laser vitreolysis is an outpatient procedure and has a relatively short recovery time.

Topical NSAIDs and steroid medications can be administered to reduce pain and inflammation, but many times patients are asymptomatic after the procedure. (Quick review of cap colors for ocular medications here.) Risks of a laser vitreolysis are consistent with other ocular surgeries and should be reviewed prior to the procedure. A 2017 study JAMA Opthalmology showed that YAG decreased the symptoms of vitreous floaters.

There is a relatively small risk for an iritis, but complications like cystoid macular edema and retinal detachment are possible, just like with a vitrectomy. For many patients, laser vitreolysis may not be effective enough to eliminate their symptoms, but for others, this procedures provides a healthy alternative to surgery.

Regardless of what your doctor recommends, there are now several contemporary options for patients who suffer from vitreous floaters. As the scope of optometry expands, you can be sure that YAG procedures and other new technologies will usher in a new wave of treatment options for our patients.