Minimally-invasive laser eye treatment for floaters

Written in association with: Mr Vaughan Tanner
Published:
Edited by: Laura Burgess

Those squiggly lines, small specks and shapes that often look like cobwebs, which dart away when you try to see them more clearly, are called eye floaters. In the vast majority of patients, these are a minor irritation with no need for treatment. However, there is increasing recognition in scientific studies that floaters can have a serious impact on a patient’s vision and quality of life.

Thankfully, laser eye treatment known as YAG laser vitreolysis is a minimally-invasive, pain-free procedure that can dramatically reduce the visual disturbance caused by floaters. Here, one of our top ophthalmologists Mr Vaughan Tanner explains everything that you need to know about the procedure, including what happens during the treatment.

 

Close-up image of an eye

What is YAG vitreolysis?

Laser treatment has improved significantly in recent years with much better laser focusing, which allows for safer treatment. Vitreolysis involves the application of nanosecond pulses of laser light to vaporise the vitreous opacities and to cut vitreous strands. Laser vitreolysis uses a Neodymium: Yttrium-Aluminium Garnet (Nd: YAG) laser to vaporise the floaters within the eye.

The end result is that the floater is either removed or reduced to a size that no longer impedes vision.
 

Who is suitable for vitreolysis?

Patients over the age of 45 are usually the best candidates. Younger patients tend to have microscopic floaters located close to the retina, which is not considered ideal for vitreolysis treatment. The procedure is usually offered to patients who have had persistent symptoms for more than six months and who have large, well-defined floaters that sit away from the retina.
 

What happens during the procedure?

Vitreolysis is a day case procedure, which means that you do not have to stay overnight in a hospital. Prior to treatment, you will have anaesthetic eye drops administered. A contact lens is placed on your eye with the laser light delivered through a specifically designed laser microscope.

The laser is carefully aimed at either the floaters or their attachments. During treatment, the patient will see small, dark specks, which are the floaters being vaporised into small gas bubbles. These bubbles quickly dissolve into the vitreous.

The treatment session takes between 10-30 minutes but depends on the size and extent of the floaters. Most patients will need to undergo two to three treatment sessions to achieve a satisfactory result as it is not possible to eliminate all floaters in one sitting.
 

What can I expect after YAG vitreolysis treatment?

Some patients may experience mild discomfort, redness or temporarily blurred vision immediately after treatment. There may be small, dark specks in the lower field of vision straight after the procedure, which are gas bubbles that will quickly dissolve.
 

Are there any complications and side effects?

The reported side effects and complications associated with vitreolysis are rare. Possible complications may include the development of cataract, retinal damage, intraocular pressure (IOP) spike and potential loss of vision (less than 1%).

If floaters persist following vitreolysis, the patient may want to consider surgical vitrectomy. Surgery is very effective but more invasive with a higher risk of problems.

Read more on vitrectomy surgery

If you would like to discuss your treatment options for floaters, you can book an appointment with Mr Tanner via his Top Doctor’s profile.

By Mr Vaughan Tanner
Ophthalmology

Mr Vaughan Tanner has over 20 years experience as a senior consultant ophthalmic surgeon to The Royal Berkshire Hospital, Reading and King Edward VII Hospital, Windsor. During that time, he led the Berkshire-wide vitreo-retinal surgical service, established a sub-specialist age-related macular degeneration service, provided a micro-incision cataract service and headed a general ophthalmic team providing care for acute and routine eye conditions. He now focuses on providing a private practice, centre of excellence for both cataract and retinal surgery. His subspecialist interests and recent advances include the introduction of sub-2mm micro-incision cataract extraction with multifocal and toric lens implants designed to significantly reduce spectacle dependence following cataract surgery.
 
He has also developed sutureless small incision vitrectomy techniques for the repair of retinal detachment, epiretinal membrane, macular hole and other vitreoretinal diseases. Mr Tanner’s extensive surgical experience includes the performance or supervision of over 15,000 major intraocular cataract and retinal procedures.

Mr Tanner has led the introduction of many new retinal treatments including Faricimab, Lucentis, Eylea anti-growth factor, intravitreal injections and Ozurdex steroid implants. These innovations have significantly improved vision for many patients suffering from age-related macular degeneration, diabetic retinopathy, retinal vein occlusion and other retinal problems.

In the private sector, he has developed a comprehensive service aiming to provide the highest level of personal care using the latest surgical techniques available. His main practice covers Berkshire, Oxfordshire, Surrey, Buckinghamshire, Hampshire and London with many national and international referrals. Private consultations and treatments are available at the following The Princess Margaret Hospital, Windsor, Dunedin Hospital, Reading and Circle Hospital, Reading.

His undergraduate study was at St George’s Hospital Medical School, London where he was awarded Medical Research Council funding in addition to his medical degree. His completion of higher surgical training at the Oxford Eye Hospital led to the award of the Fellowship of the Royal College of Ophthalmologists. He then completed three years of advanced, sub-specialist fellowships at both Moorfields Eye Hospital, London and St Thomas’ Hospital, London. During this period he gained expertise in the surgical and medical management of all retinal disorders including macular surgery. He has co-authored “Diseases of the Ocular Fundus” which was awarded first prize as “Best Authored Post Graduate Textbook” by the Royal Society of Medicine and the Royal Society of Authors. He has previously hosted both the Southern and National Annual Meetings of the British and Eire Association of Vitreo-Retinal Surgeons. He is an invited scientific reviewer for the British Journal of Ophthalmology.

Furthermore, Mr Tanner was a consultant clinical supervisor for The Oxford Deanery School of Ophthalmology responsible for post-graduate training and also led a fellowship training programme in advanced vitreo-retinal surgical techniques for surgeons becoming consultants in this sub-specialty. He has previously been appointed both lead clinician and clinical governance lead for the ophthalmology department, Royal Berkshire Hospital and has been awarded three NHS clinical excellence awards. He is currently appointed ophthalmology lead for the Medical Advisory Committee at Princess Margaret Hospital, Windsor.

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