YAG Laser Vitreolysis for Symptomatic Vitreous Floaters
Importance
Vitreous floaters are common and can worsen visual quality. YAG vitreolysis is an untested treatment for floaters.
Objective
To evaluate YAG laser vitreolysis vs sham vitreolysis for symptomatic Weiss ring floaters from posterior vitreous detachment.
Design, Setting, and Participants
This single-center, masked, sham-controlled randomized clinical trial was performed from March 25, 2015, to August 3, 2016, in 52 eyes of 52 patients (36 cases and 16 controls) treated at a private ophthalmology practice.
Interventions
Patients were randomly assigned to YAG laser vitreolysis or sham YAG (control).
Main Outcomes and Measures
Primary 6-month outcomes were subjective change measured from 0% to 100% using a 10-point visual disturbance score, a 5-level qualitative scale, and National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes included objective change assessed by masked grading of color fundus photography and Early Treatment Diabetic Retinopathy Study best-corrected visual acuity.
Results
Fifty-two patients (52 eyes; 17 men and 35 women; 51 white and 1 Asian) with symptomatic Weiss rings were enrolled in the study (mean [SD] age, 61.4 [8.0] years for the YAG laser group and 61.1 [6.6] years for the sham group). The YAG laser group reported greater symptomatic improvement (54%) than controls (9%) (difference, 45%; 95% CI, 25%-64%;P < .001). In the YAG laser group, the 10-point visual disturbance score improved by 3.2 vs 0.1 in the sham group (difference, −3.0; 95% CI, −4.3 to −1.7;P < .001). A total of 19 patients (53%) in the YAG laser group reported significantly or completely improved symptoms vs 0 individuals in the sham group (difference, 53%; 95% CI, 36%-69%,P < .001). Compared with sham, NEI VFQ-25 revealed improved general vision (difference, 16.3; 95% CI, 0.9-31.7;P = .04), peripheral vision (difference, 11.6; 95% CI, 0.8-22.4;P = .04), role difficulties (difference, 17.3; 95% CI, 8.0-26.6;P < .001), and dependency (difference, 5.6; 95% CI, 0.5-10.8;P = .03) among the YAG laser group. Best-corrected visual acuity changed by −0.2 letters in the YAG laser group and by −0.6 letters in sham group (difference, 0.4; 95% CI, −6.5 to 5.3;P = .94). No differences in adverse events between groups were identified.
Conclusions and Relevance
YAG laser vitreolysis subjectively improved Weiss ring–related symptoms and objectively improved Weiss ring appearance. Greater confidence in these outcomes may result from larger confirmatory studies of longer duration.
Trial Registration
clinicaltrials.govNCT02897583
Publisher URL: http://jamanetwork.com/journals/jamaophthalmology/fullarticle/2643488
DOI: 10.1001/jamaophthalmol.2017.2388
Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.
Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.