Abstract
Purpose :
The purpose of this study was to identify complications and subjective rates of improvement in a patient population that received Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) vitreolysis for symptomatic vitreous floaters.
Methods :
All patients who underwent Nd:YAG vitreolysis for symptomatic floaters were retrospectively identified from January 1, 2015 to October 31st, 2019 at the University of Minnesota Medical Center. Primary outcomes were adverse events and patient reported subjective symptomatic changes following treatment. Secondary outcomes included visual acuity and intraocular pressure (IOP) before and after treatment. A standardized questionnaire was used to rate floater symptoms on a scale of 1 to 10 after treatments were completed (1=unnoticeable, 10=unbearable). Patients were also asked if they would choose to have another laser treatment for floaters if symptoms return. The paired t-test was used to compare pre- and post-procedure visual acuities, IOP, and questionnaire ratings (P<0.05).
Results :
129 treatments in 80 eyes of 62 patients were identified. Twelve (15%) eyes were referred for possible pars plana vitrectomy. Six (7.50%) eyes were lost to follow-up since their last treatment. Three (3.75%) eyes experienced adverse events consisting of a transient IOP increase, posterior subcapsular cataract formation, mild vitreous hemorrhage, and an episode of vasovagal syncope. No complications were visually significant. 53 (85%) patients indicated that they would repeat the laser treatment if symptoms return. Pre- and post-treatment visual acuity was not statistically different. Pre- and post-treatment IOP was statistically different, with lower IOP after treatment. Symptomatic improvement was found to be statistically significant (p<0.0001) (Table 1).
Conclusions :
Our findings demonstrate high rates of subjective symptomatic improvement with rare complications necessitating regular peri-operative follow-up. None of the encountered complications were visually significant. These results increase the available evidence that Nd:YAG vitreolysis for floaters is a reasonable treatment option for persistently symptomatic syneresis. Future prospective and larger sample size studies are needed to define the incidence of complication with Nd:YAG vitreolysis and the effect on IOP.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.