Laser Vitreolysis of Symptomatic Vitreous Floaters. Report 2. Prospective Analysis

Objective: to conduct a prospective assessment of the safety and clinical efficacy of early laser vitreolysis for symptomatic Weiss ring vitreous floaters in the presence of complete posterior vitreous detachment (PVD) over a 12-month period.
Methods. The study included 160 patients (160 eyes) with symptomatic Weiss ring vitreous floaters and complete posterior vitreous detachment. Patients were divided into groups based on the timing of treatment: early laser vitreolysis (ELV) — within 3 months, delayed laser vitreolysis (DLV) — 3 months or more, and a control group (no treatment). Laser vitreolysis was performed using the Ultra Q Reflex YAG laser system.
Results. Safety analysis of ELV showed no statistically significant differences with the DLV and control groups in the rate of intra- and postoperative complications, intraocular pressure level, or ocular morphometric parameters. Analysis of the efficacy of ELV for Weiss ring revealed complete elimination of the floater in 74.5 % of cases after laser vitreolysis, comparable to the DLV group — 63.5 % (p > 0.05); a high functional outcome — improvement in best-corrected visual acuity (BCVA) by 0.176 vs. 0.048 in the control group (p < 0.001) and comparable to the DLV group — 0.123 (p > 0.05); subjective improvement in “quality of life” across all categories (overall QoL score — 66.15 % vs. 8.24 % in controls (p < 0.001) and comparable to the DLV group — 65.49 %, p > 0.05); a high self-assessed satisfaction rate with the ELV result — 72.7 % reported “complete success”, comparable to the DLV group — 59.6 %; a reduction in complaints of visual discomfort by 79.9 % vs. 8.7 % (p < 0.001) in the control group, comparable to the DLV group — 77.3 % (p > 0.05).
Conclusion. Based on the study data, performing early YAG laser vitreolysis for symptomatic Weiss ring vitreous floaters in the presence of complete PVD is a safe and highly effective method and can be considered a justified alternative to observational management in patients with clinically significant symptomatic floaters.

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