Laser Vitreolysis of Symptomatic Vitreous Floaters. Report 1. Retrospective Analysis
https://doi.org/10.18008/1816-5095-2025-3-531-537
Abstract
Purpose: To perform a retrospective study and evaluate patient satisfaction rates and the incidence of complications associated with YAG laser vitreolysis for symptomatic Weiss ring floaters, comparing early and delayed intervention timing following posterior vitreous detachment (PVD). Methods. A retrospective analysis of laser vitreolysis (LV) was conducted over the period from August 2016 to December 2024 (400 weeks) using outpatient records of 966 patients (1187 eyes, 1532 treatment sessions). Two study groups were identified based on the time from appearance of Weiss ring symptomatic floaters (SF): Group I (early vitreolysis) — 309 patients (355 eyes), treated within 3 months with complete PVD. Laser vitreolysis was performed using the Ultra Q Reflex laser system (Ellex Medical Lasers, Australia). Results: Retrospective studies of early and delayed vitreolysis showed high patient satisfaction rates (93.8% and 91.6%, respectively) and low incidence of laser vitreolysis complications (0.2% and 0.4%, respectively). Conclusion. YAG laser vitreolysis is a safe and effective method for treating symptomatic vitreous floaters with high patient satisfaction rates. Early vitreolysis of Weiss ring symptomatic floaters with complete PVD is the treatment of choice for laser therapy.
About the Authors
V. A. ShaimovaRussian Federation
Venera A. Shaimova - МD, Professor of the Ophthalmology department.
Volokolamskoye highway, 91, Moscow, 125371; Komsomolsky ave., 99D, Chelyabinsk, 454021
S. Kh. Kuchkildina
Russian Federation
Sirina Kh. Kuchkildina – ophthalmologist.
Komsomolsky ave., 99D, Chelyabinsk, 454021
T. B. Shaimov
Russian Federation
Timur B. Shaimov - PhD, ophthalmologist.
Komsomolsky ave., 99D, Chelyabinsk, 454021
R. B. Shaimov
Russian Federation
Ruslan B. Shaimov - PhD, director, ophthalmic surgeon.
Komsomolsky ave., 99D, Chelyabinsk, 454021
J. V. Nosul
Russian Federation
Yuliya V. Nosul – ophthalmologist.
Rumyantseva str., 28, Chelyabinsk, 454017
M. S. Ivin
Russian Federation
Mikhail S. Ivin – student.
Vorovskogo str., 64, Chelyabinsk, 454048
O. V. Galina
Russian Federation
Olga V. Galina – ophthalmologist.
40-letuya Oktyabrya str., 15/1, Chelyabinsk, 454007
A. Yu. Galin
Russian Federation
Aleksei Yu. Galin – ophthalmologist.
40-letuya Oktyabrya str., 15/1, Chelyabinsk, 454007
References
1. Sun X, Tian J, Wang J, Zhang J, Wang Y, Yuan G. Nd:YAG Laser Vitreolysis for Symptomatic Vitreous Floaters: Application of Infrared Fundus Photography in Assessing the Treatment Efficacy. J Ophthalmol. 2019;2019:8956952. doi: 10.1155/2019/8956952.
2. Lin T, Li T, Zhang X, Hui Y, Moutari S, Pazo EE, Dai G, Shen L. The Efficacy and Safety of YAG Laser Vitreolysis for Symptomatic Vitreous Floaters of Complete PVD or Non-PVD. Ophthalmol Ther. 2022;11(1):201–214. doi: 10.1007/s40123-021-00422-6.
3. Woudstra-de Jong JE, Manning-Charalampidou SS, Vingerling H, Busschbach JJ, Pesudovs K. Patient-reported outcomes in patients with vitreous floaters: a systematic literature review. Surv Ophthalmol. 2023;68(5):875–888. doi:10.1016/j.survophthal.2023.06.003.
4. Partin M, Lighthizer N. Sinking the Floaters. With laser indications proliferating, optometry can do more to address patients troubled by the benign debris. Review of Optometry. 2020;157(2):80–86.
5. Kim YK, Moon SY, Yim KM, Seong SJ, Hwang JY, Park SP. Psychological distress in patients with symptomatic vitreous floaters. J Ophthalmol. 2017;2017:3191576. doi: 10.1155/2017/3191576.
6. Sebag J, Yee KM, Wa CA, Huang LC, Sadun AA. Vitrectomy for floaters: prospective efficacy analyses and retrospective safety profile. Retina. 2014;34(6):1062–1068. doi: 10.1097/iae.0000000000000065.
7. Hahn P, Schneider EW, Tabandeh H, Wong RW, Emerson GG; American Society of Retina Specialists Research and Safety in Therapeutics (ASRS ReST) Committee. Reported complications following laser vitreolysis. JAMA Ophthalmol. 2017;135(9):973–976. doi: 10.1001/jamaophthalmol.2017.2477.
8. Garcia GA, Khoshnevis M, Yee KMP, Nguyen-Cuu J, Nguyen JH, Sebag J. Degradation of contrast sensitivity function following posterior vitreous detachment. Am J Ophthalmol. 2016;172:7–12. doi: 10.1016/j.ajo.2016.09.005.
9. Wagle AM, Lim WY, Yap TP, Neelam K, Au Eong KG. Utility values associated with vitreous floaters. Am J Ophthalmol. 2011;152(1):60–65.e1. doi: 10.1016/j.ajo.2011.01.026.
10. Hangshuai Z, Yanhua J, Yao Z, Guangjin Z, Hongyan W, Fanlian C. Efficacy and safety of early YAG laser vitreolysis for symptomatic vitreous floaters: the study protocol for a randomized clinical trial. Trials. 2024;25(1):48. doi:10.1186/s13063-024-07924-1.
11. Rostami B, Nguyen-Cuu J, Brown G, Brown M, Sadun AA, Sebag J. Cost-effectiveness of limited vitrectomy for vision-degrading myodesopsia. Am J Ophthalmol. 2019;204:1–6. doi: 10.1016/j.ajo.2019.02.032.
12. Sebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res. 2020;79:100847. doi: 10.1016/j.preteyeres.2020.100847.
13. Ivanova T, Jalil A, Antoniou Y, Bishop PN, Vallejo-Garcia JL, Patton N. Vitrectomy for primary symptomatic vitreous opacities: an evidence-based review. Eye (Lond). 2016;30(5):645–655. doi: 10.1038/eye.2016.30.
14. Su D, Shah CP, Hsu J. Laser vitreolysis for symptomatic floaters is not yet ready for widespread adoption. Surv Ophthalmol. 2020;65(5):589–591. doi: 10.1016/j.survophthal.2020.02.007.
15. Brasse K, Schmitz-Valckenberg S, Jünemann A, Roider J, Hoerauf H. YAG-Laser-Vitreolyse zur Behandlung von störenden Glaskörpertrübungen [YAG laser vitreolysis for treatment of symptomatic vitreous opacities]. Ophthalmologe. 2019;116(1):73–84 (In German). doi: 10.1007/s00347-018-0782-1.
16. Schmitz-Valckenberg S, Brasse K, Hoerauf H. Degenerative Glaskörpertrübungen [Vitreous floaters]. Ophthalmologe. 2020;117(5):485–496 (In German). doi: 10.1007/s00347-020-01094-6.
17. Singh IP. Modern vitreolysis-YAG laser treatment now a real solution for the treatment of symptomatic floaters. Surv Ophthalmol. 2020;65(5):581–588. doi: 10.1016/j.survophthal.2020.02.006.
18. Katsanos A, Tsaldari N, Gorgoli K, Lalos F, Stefaniotou M, Asproudis I. Safety and Efficacy of YAG Laser Vitreolysis for the Treatment of Vitreous Floaters: An Overview. Adv Ther. 2020;37(4):1319–1327. doi: 10.1007/s12325-020-01261-w.
19. Milston R, Madigan MC, Sebag J. Vitreous floaters: etiology, diagnostics, and management. Surv Ophthalmol. 2016;61(2):211–227. doi: 10.1016/j.survophthal.2015.11.008.
20. Shaimova VA, ed. Vitreous floaters: diagnosis, treatment, complications: atlas. Saint Petersburg: Chelovek; 2022 (In Russ.).
21. Luo J, An X, Kuang Y. Efficacy and safety of yttrium-aluminium garnet (YAG) laser vitreolysis for vitreous floaters. J Int Med Res. 2018;46(11):4465–4471. doi: 10.1177/0300060518794245.
22. Shah CP, Heier JS. YAG Laser Vitreolysis vs Sham YAG Vitreolysis for Symptomatic Vitreous Floaters: A Randomized Clinical Trial. JAMA Ophthalmol. 2017;135(9):918–923. doi: 10.1001/jamaophthalmol.2017.2388.
23. Shaimova VA, Shaimov TB, Galin AYu, Shaimov RB, Kravchenko TG, Titova SV. OCT visualization of vitreous floaters for evaluation of the efficiency of laser vitreolyzis. Otrazhenie. 2019;2:45–50 (In Russ.). doi: 10.25276/2686-6986-2019-2-45-50.
24. Shaimova VA, Kuchkildina SKh, Islamova GR, Titova SV, Dmukh TS, Kravchenko TG. A research of the efficiency and safety of YAG-laser vitreolysis in the early period of complete posterior vitreous detachment. Otrazhenie. 2022;2:43–45 (In Russ.). doi: 10.25276/2686-6986-2022-2-39-41.
25. Shaimova VA, Kuchkil’dina SKh, Islamova GR. Early laser vitreolysis: atlas. Saint Petersburg: Chelovek; 2023 (In Russ.).
26. Singh IP. Novel OCT Application and Optimized YAG Laser Enable Visualization and Treatment of Mid-to Posterior Vitreous Floaters. Ophthalmic Surg Lasers Imaging Retina. 2018;49(10):806–811. doi: 10.3928/23258160-20181002-10.
27. Jang HW, Chun SH, Park HC, Ryu HJ, Kim IH. Comparative study of dual-pulsed 1064 nm Q-switched Nd:YAG laser and single-pulsed 1064 nm Q-switched Nd:YAG laser by using zebrafish model and prospective split-face analysis of facial melasma. J Cosmet Laser Ther. 2017;19(2):114–123. doi: 10.1080/14764172.2016.1262958.
28. Lin T, Wang D, Shen L. An energy efficiency assessment of Yttrium-aluminum-garnet laser in vitro. Lasers Med Sci. 2024;39(1):97. doi: 10.1007/s10103-024-04041-y.
29. Delaney YM, Oyinloye A, Benjamin L. Nd:YAG vitreolysis and pars plana vitrectomy: surgical treatment for vitreous floaters. Eye (Lond). 2002;16(1):21–26. doi: 10.1038/sj.eye.6700026.
30. Tsai WF, Chen YC, Su CY. Treatment of vitreous floaters with neodymium YAG laser. Br J Ophthalmol. 1993;77(8):485–488. doi: 10.1136/bjo.77.8.485.
31. Ankamah E, Pavičić-Astaloš J, Budimlija N, Ibrahim F, Kirwan C, Hayes P, Ng E. Nd:YAG laser vitreolysis for managing symptomatic vitreous floaters: efficacy assessment using vitreous opacity area quantification. Research Square. Posted Feb 10, 2023. doi: 10.21203/rs.3.rs-2565214/v1.
32. Thompson P, Mammo D, Roston S, Olson J. Subjective Improvement and Complications following Neodymium-doped Yttrium Aluminum Garnet Vitreolysis. Invest Ophthalmol Vis Sci. 2022;63(7):3799–F0220.
33. Ludwig GD, Gemelli H, Nunes GM, Serracarbassa PD, Zanotele M. Efficacy and safety of Nd:YAG laser vitreolysis for symptomatic vitreous floaters: A randomized controlled trial. Eur J Ophthalmol. 2021;31(3):909–914. doi: 10.1177/1120672120968762.
Review
For citations:
Shaimova V.A., Kuchkildina S.Kh., Shaimov T.B., Shaimov R.B., Nosul J.V., Ivin M.S., Galina O.V., Galin A.Yu. Laser Vitreolysis of Symptomatic Vitreous Floaters. Report 1. Retrospective Analysis. Ophthalmology in Russia. 2025;22(3):531-537. (In Russ.) https://doi.org/10.18008/1816-5095-2025-3-531-537