Inder Paul Singh, MD, an ophthalmologist with the Eye Centers of Racine and Kenosha in Wisconsin, conducted a study of patients who had laser treatment to vaporize the flecks and spots that drift through peoples' fields of vision, all of whom showed a very low complication rate. Additionally, most patients reported a significant improvement in their vision.
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Collecting long-term safety data is vital to determine the effectiveness of lasers for these flecks and spots, which are known as eye floaters. To that end, Singh shared his results with 680 patients, who collectively underwent 1272 laser procedures for large eye floaters. He saw these patients anywhere from one to four years to check for complications. Only 0.8% experienced a complication—the most common complication being an increase in intraocular pressure, which was successfully treated with an antihypertensive eyedrop.
Most eye floaters are bits of a protein called collagen, and are part of a gel-like substance in the back of the eye called the vitreous. About one-quarter of people have some vitreous changes with eye floaters by age 60. By age 80, the number rises to about two-thirds. People are more likely to have them if they are nearsighted or have had cataract surgery. Those with large floaters experience significant interference with their vision and daily functioning—a 2013 study found that about one-third of patients say floaters interfere with their daily activities.
Using a laser to break up larger floaters into smaller pieces so they are less visually disabling dates back to the 1980s. But most physicians counseled against using lasers to treat floaters because of reports that the laser could not properly visualize floaters, which could lead to inadvertent damage to the lens or retina.
As laser technology has advanced, newer-generation lasers have been designed to maximize visualization of the floaters in relation to the lens and retina. Energy is delivered more efficiently to break up or even vaporize floaters. These improvements have raised the possibility that treatment of floaters could become a mainstream procedure in ophthalmology.
"The procedure and new technique is slowly growing in acceptance, and an increasing number of ophthalmologists are adopting it in Europe and the U.S.," Singh says. "We have also founded the International Ophthalmic Floater Society, which is open to ophthalmologists worldwide. It's aimed at studying the merits of this and other treatment options, sharing experiences and protocols, and raising awareness."
Singh's research was presented on November 13, 2017, at the 121st Annual Meeting of the American Academy of Ophthalmology (AAO 2017) in New Orleans, LA. For more information, please visit www.aao.org.