YAG Laser Treatment Reduces Eye Floaters
Floaters are tiny specks or cobweb-like particles that seem to float across your eye. They increase with age and are seldom serious, but if they increase dramatically or suddenly, they can be a sign of retinal tearing or detachment; left untreated, your vision could be permanently harmed. (Retinal detachment appears as a black curtain falling over the eye that affects side vision; it also may manifest as flashing lights.) Treating floaters with YAG laser treatment reduces or eliminates the floaters, increasing and improving vision.
What is YAG? YAG laser stands for Yttrium-Aluminum Garnet, a crystal used as a lasing medium for solid-state lasers. In eye surgery, the YAG laser uses laser light in a focused beam to make small openings in the eye’s posterior capsule to clear the clouded membrane. It is used also to treat secondary cataracts, which form from continued protein production, which clouds the capsule. The laser vaporizes floaters within the eye.
Another Kind of Floater. A Weiss ring is a floater that appears as a ring shape, and is generally larger than other floaters. It is composed of fibroglial tissue that free floats over the optic nerve, and is a marker of posterior vitreous detachment (PVD). A PVD allows the vitreous body to move when the head or eye moves, thus casting shadows onto the retina that are perceived as floaters. (About 65 percent of patients over the age of 65 have a PVD.)
Treatment Options. For symptomatic floaters, three treatment options exist: patient education and observation; vitrectomy (used to remove vitreous gel from the middle of the eye if there is retinal detachment or blood in the vitreous gel) with a one-incision intrector (limited core vitrectomy), and YAG vitreolysis.
The current, randomized clinical trial evaluated YAG vitreolysis in patients with symptomatic Weiss rings. A total of 52 patients were involved; 16 were assigned to sham treatment, and 36 to YAG vitreolysis.
Improvements Reported. The YAG group reported 54 percent improvement in visual symptoms versus 9 percent reported by the sham group. No adverse events were reported in the six-month, post-operative follow-up, and the YAG group also reported improvements in near and distance vision, and mental health.
The procedure is not without flaws, says Jennifer I. Lim, MD, with the Illinois Eye and Ear Infirmary, University of Illinois (Chicago), who provided editorial commentary accompanying the July 20, 2017 online publication of the study in JAMA Ophthalmology. Dr. Lim suggested that patients be counseled and observed for the first year after diagnosis before moving to YAG vitreolysis. The authors also report that a larger sample size is needed to detect infrequent, but perhaps devastating, complications.
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