The use of laser floater removal dates back to the eighties when Professor Aron Rosa, Paris, France, and Professor Franz Fankhauser, Berne, Switzerland, who were pioneers in the use of YAG lasers, published on their success with vitreolysis. Fast-forward 10 years and YAG lasers were designed exclusively for disrupting posterior capsules and for performing iridotomies – the technical design of which made it difficult to use these YAG lasers in the posterior segment. Indeed, conventional YAG lasers provide a limited view of the vitreous, which can make it difficult to identify the targeted membranes and opacities. The design of these conventional YAG lasers is such that they carry a high risk of damage to surrounding ocular tissue.
Ophthalmic YAG Laser Treatment: An Overview
Anterior YAG Laser Treatment: Capsulotomy and Iridotomy
In general, ophthalmic YAG lasers are designed for use in the anterior segment to perform capsulotomy (anterior and posterior) following IOL implantation, and to perform iridotomy prior to implanting an anterior chamber lens, or in cases of angle closure glaucoma. During these procedures, the highly concentrated beam of laser light is applied for a few nanoseconds to reach a power density sufficient to produce a small explosion, which ruptures the tissue at the focal point. This is referred to as optical breakdown.
Posterior YAG Laser Treatment: Laser Floater Removal
Ophthalmic YAG lasers can also be designed for use in the vitreous cavity to perform laser floater removal. During this procedure, the laser light is used to create a small plasma explosion within the vitreous in order to treat vitreous strands and opacities. Sometimes referred to as “floater busting”, laser floater removal offers a number of benefits to both patient and physician. The goal of laser floater removal is to achieve a functional improvement. That is, to allow the patient to return to “normal” day-to-day activities without the hindrance of floaters. Today, Ellex is the only company to offer a YAG laser, which is designed for performing both anterior and posterior YAG treatments: Ultra Q Reflex.
The Laser Floater Removal Procedure
Laser floater removal is an outpatient-based procedure, which involves the use of a specially designed YAG laser to vaporize the vitreous strands and opacities. Highly effective, it has a low complication rate and offers a high degree of patient satisfaction. It can also delay or obviate the need for surgery.
Using a laser lens placed on the patient’s eye, the YAG laser is focused onto the front surface of the floater. The laser emits a short 3 nanosecond (0.000000003 seconds) burst of energy. It is important to note that the laser energy does not simply break the floater into smaller pieces. Instead, the high power density of this laser energy converts the collagen and hyaluronin molecules to a gas, which is then resorbed into the eye.
Animation: Laser Floater Removal
Laser floater removal is a simple, outpatient-based procedure, which involves the use of a nano-pulsed ophthalmic YAG laser to vaporize vitreous strands and opacities. Highly effective, it has a low complication rate and offers a high degree of patient satisfaction. It can also delay or obviate the need for surgery. Watch this animation to see how quickly – and easily – laser floater removal can be used to vaporize floaters.