Therapeutic Efficacy And Safety Of Nd:YAG Laser In The Treatment Of Primary Vitreous Floaters

ObjectiveTo observe and study the clinical efficacy and safety of Nd:YAG vitreous laser vitreolysis in the treatment of primary vitreous floaters,and to evaluate the changes of subjective feeling and objective visual quality after Nd:YAG vitreous laser vitreolysis.To analyze the effects of Nd: YAG vitreous laser vitreolysis on patients’ near distance vision,far distance vision,detail resolution,and mood of daily life.To compare the differences of subjective and objective evaluation results between the Weiss ring group and the non-Weiss ring group.MethodsThis study was a prospective,single-center cohort study,51 patients(51 eyes)who were admitted to the He Eye Specialist Hospital of Shenyang on February 1,2020 to June 30,2020 and diagnosed as primary vitreous floaters by slit lamp front mirror combined with B-type ultrasound examination and underwent vitreous laser vitreolysis with Nd:YAG and completed follow-up were selected.There were 37 female patients(37 eyes)and 14 male patients(14 eyes),ranging in age from 24 to 76 years old(mean age 56.80±10.82).The average number of laser treatment was 663.65±354.96.According to whether the presence of Weiss ring was observed in the fundus examination under the slit lamp front mirror compound Tropicamide Phenylephrine eye drops fully mydriasis,all the patients were divided into two groups: the non-Weiss ring group and the Weiss ring group,and 33 eyes(64.71%)were non-Weiss ring type and the rest were Weiss ring type.The intraocular high order aberration,modulation transfer function(MTF)of 4millimeter below the natural pupil of all affected eyes were measured by OPD-SCANIII(Nidex,Japan)preoperatively and 6 months postoperatively.Using SLO(ultra-wide Angle fundus scanning photography,OPTOS (?) 200 TX,OPTOS (?),Dunfermline,UK)for fundus scanning photography and with its own software to measure the area of floaters,and vitreous floaters questionnaire was used to score all patients.For the all have eyes BCVA(best corrected visual acuity)measurement,slit lamp examination and lead the microscopic fundus examination,eliminate unstable retinal degeneration,retinal tear and so on.All patients underwent laser-related procedures performed by the same experienced retinologist.The efficacy of YAG vitreous laser vitreolysis in the treatment of floaters was evaluated by comparing subjective and objective parameters before and 6 months after surgery.The effects of YAG vitreous laser vitreolysis on near distance vision,far distance vision,detail resolution,and mood of daily life from questionnaire were also analyzed.Pair sample t-test or Mc Nemar nonparametric test were used for statistical analysis of all results with SPSS.The software version was 25.0(SPSS Inc,Chicago,USA),and P〈0.05 was statistically significant.ResultsThirty-seven of 51(72.55%)patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment.MTF and intraocular high order aberration were significant better compared to baseline(P=0.048 and 0.012,respectively).YAG laser vireolysis for primary vitreous floaters could improve detail resolution,and mood of daily life significantly(P=0.002 and 0.007,respectively).The significant or complete improve rates of the non-Weiss ring group and the Weiss ring group were 72.22% and 69.70%(P=0.225)on the subjective questionnaire,and 83.33%and 100%(P=0.162)on the objective assessment,respectively.None of the 51 eyes in this study had complications related to Nd: YAG laser.ConclusionUsing Nd:YAG laser to crush the vitreous floaters and promote its absorption is an effective method for the treatment of vitreous floaters.The subjective and objective visual quality of patients with symptomatic floaters both improve after YAG laser vitreolysis.YAG laser vireolysis is a considerable treatment option for primary symptomatic floaters and is worthy of clinical application and promotion.