Vitreous Floaters—Under Appreciated and Under Treated Problem: Patient Satisfaction and Complications of YAG Vitreolysis
Purpose
To assess the impact of yttrium aluminium garnet (YAG) vitreolysis on patient satisfaction and to determine the rate of complications with this procedure
Methods
This retrospective, observational study included 296 eyes of n=198 patients (mean age, 66 years [range, 38 to 89 years]) who underwent YAG vitreolysis with the Ultra Q Reflex&trade (Ellex Medical Lasers, Adelaide, Australia), a neodymium-doped (Nd) YAG laser in an office outpatient setting. [Power range 2.0 mj - 5.5 mj] Patient satisfaction was assessed with a 1−10 self-rated scale, with higher values indicating greater patient satisfaction as well as a “Yes” or “No” indicating whether they were satisfied with improvement in daily functioning. Information on complications was recorded for all patients
Results
We observed one case of intraocular pressure spike requiring IOP lowering meds; two phakic lenses were hit, one of which required cataract surgery. No retinal complications were seen without anterior chamber or vitreous reaction.
93% of patients answered “yes” when asked if they were satisfied with their improvement in daily functioning . Average degree of improvement was 8.2/10. Best results were seen with solitary weiss rings verses amorphous “clouds.” Average number of sessions per eye was 1.7. Average number of shots was 315; more shots were used for amorphous floaters. The average power setting was 3.8 mJ.
Conclusion
Nd: YAG vitreolysis is associated with a high degree of patient satisfaction, similar to that with procedures such as cataract surgery and refractive surgery. The procedure has an excellent risk/benefit ratio and can be considerred as a first line treatment for symptomatic floaters.