Short-Term Clinical Results and Safety of Ultra Q Laser Treatment for Vitreous Floaters

PURPOSE: To evaluate the short-term clinical results and safety of Ultra Q neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment for vitreous floaters. METHODS: The present study included 31 eyes of 31 patients with symptomatic floaters lasting more than 3 months. The vitreous floaters were photodisrupted using Ultra Q Nd:YAG laser. Preoperative and postoperative best corrected visual activity (BCVA) and intraocular pressure, change of the floater, patient satisfaction and postoperative complications were analyzed prospectively. RESULTS: There was no significant difference between preoperative and postoperative BCVA and intraocular pressure (p > 0.05). Vitreous floaters were not found in 9 eyes (29.03%), decreased floaters were observed in 19 eyes (61.29%) and definite change of floaters was not observed in 3 eyes (9.68%). Patient satisfaction after the laser treatment was very satisfied in 11 eyes (35.48%) and satisfied in 20 eyes (64.58%). Satisfaction in Weiss ring type of the floater was the highest, very satisfied in 6 of the 8 eyes (75%) and vitreous floaters were not observed in 7 of the 8 eyes (87.50%). Postoperative complications were not observed during a follow-up period of at least 3 months. CONCLUSIONS: Ultra Q Nd:YAG laser was an effective and safe treatment for the vitreous floaters in this short-term study.

Risk Factors for Retinal Breaks in Patients with Symptom of Floaters

PURPOSE: To identify the risk factors of retinal breaks in patients with symptoms of floaters and to determine the associations between those risk factors and retinal breaks. METHODS: A retrospective chart review of patients who visited with the symptom of vitreous floaters between July 2012 and October 2012 was performed. Patient information, such as age, sex, symptoms (e.g., multiple floaters and flashing), duration of symptoms, refractive error, and complete eye examination were recorded. The patients were divided into 2 groups: the control group had symptoms of floaters with no retinal breaks and the retinal breaks group had symptoms of floaters with retinal breaks. The chi-square test and univariate logistic regression were used for statistical analysis. RESULTS: A total of 1744 eyes were examined in this study, including 1706 eyes in the control group and 38 eyes in the retinal breaks group. Univariate analysis revealed that patients with high myopia and multiple floaters showed increased risk of retinal breaks by 3.4 and 4.4 times, respectively, when compared to patients with a single floater alone. Lattice degeneration and vitreous or retinal hemorrhage increased the risk of retinal breaks by 10.8 and 37.5 times when compared to eyes that did not have lattice degeneration or vitreous or retinal hemorrhage. During the follow-up period after laser photocoagulation, a new retinal tear was found in 2 patients (2/38, 5.3%). CONCLUSIONS: Vitreous or retinal hemorrhage, lattice degeneration, multiple floaters, and high myopia are risk factors of retinal breaks in patients with the symptom of floaters. Therefore, it is important for ophthalmologists to be aware of these risk factors and the patients at risk should be encouraged to attend follow-up examinations.

Management of Vitreous Floaters with Neodymium-YAG Laser

After Neodynium(Nd)-YAG laser photodisruption for vitreous floaters which were annoying the central visual field in 28 patients(28 eyes), we evaluated the efficacy of the procedure and the satisfaction degree of patients. Vitreous floaters were not recognized in 46 percents(13 eyes) of the patients, stayed away from the central visual field in 32 percents of the patients(9 eyes). Broken opacities were moved to retina in 22 percents(6 eyes) after treatment. In satisfaction degree of patients, 64 percents of the patients(18 eyes) were completely satisfied, 25 percents of them(7 eyes) were fairly satisfied, and 11 percents of them(3 eyes) were not satisfied at all. Complaints of unsatisfied patients were persisting floaters in 5 eyes, increased number of the floaters in 3 eyes and central visual field disturbance in 2 eyes. The responsible factors for failure in treatment were the size of the floaters larger than 2/3 disc diameter(DD), their locations closer than 2DD from retinal surface and their peripheral locations. Complications included the fragment shifting to posterior central zone in 2 eyes and the chorioretinal damage in 2 eyes. Our results suggest that Nd-YAG laser photodisruption seems to be useful on the discrete vitreous floaters less than 1/3DD in size and apart from retinal surface more than 2DD.