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Archive September 2017 XVIII, No. 9

Exciting Advances in Ophthalmic Laser Therapy

Taking a closer look at laser treatments for floaters, macular degeneration, diabetic retinopathy and glaucoma.

Daniel Cook

Daniel Cook, Editor-in-Chief


laser vitreolysis DIFFERENCE MAKER YAG laser vitreolysis treats floaters, a common complaint among eye patients, says ophthalmologist T. Hunter Newsom, MD, of Newsom Eye & Laser Center in Tampa and Sebring, Fla.

Many of today's eye surgeons are as skilled with the laser as they are with the scalpel, using a beam of light to pulverize floaters, create a channel within the eye to relieve intraocular pressure or treat diabetic macular edema. Here's a roundup of the latest laser platforms your surgeons can use to treat a host of eye ailments, starting with an oh-so-satisfying way to eliminate those pesky floaters.

1. YAG laser vitreolysis
Using a YAG laser on eye floaters that drift through a patient's field of vision is safe and largely effective. It's also, well, kinda fun. "Like playing a video game," says Chirag Shah, MD, MPH, a retina specialist at Ophthalmic Consultants of Boston (Mass.), as he describes tracing the tiny vapor clouds with the laser's aiming beam before pulling the trigger to blast them into oblivion. "Obviously, the stakes are much higher, but it's truly an enjoyable procedure to perform."

Floaters occur when vitreous gel separates from the retina to form large, circular shaped spots in the visual field. Dr. Shah co-authored a recent pilot study that was the first randomized control trial to assess the efficacy and safety of using a nano-pulsed YAG laser to eliminate Weiss ring floaters in the vitreous gel. In the study, 36 patients treated with the YAG laser experienced, on average, a 53% improvement in their symptoms. "But there was a broad range, meaning some patients weren't satisfied with the procedure," says Dr. Shah. Still, there was a clinically and statistically significant difference in floater reduction between patients who underwent the laser treatment, and those who did not.

Dr. Shah was encouraged by the study's findings, which, he says, demonstrate the promise of YAG laser vitreolysis. "Choos-ing patients who have reasonable expectations increases post-op satisfaction with the procedure," he says. "Some patients want vitrectomy results with the relatively low risk of YAG laser vitreolysis, and that's not possible. If you want a completely clear vitreous, you have to do a vitrectomy."

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