About Laser Treatment for Floaters

Floaters are dislodged deposits in the vitreous jelly of the eye that cause "spots" in the vision of one or both eyes. This condition can be mild and fleeting or debilitating to one's vision. Floaters aren't dangerous, though they can sometimes indicate an associated abnormality. Laser treatment is one method for ridding floaters, although only offered by a handful of surgeons in the U.S., according to the USA Today article "Treatment of eye floaters ignites debate" by Matthew Barakat.

Significance

• Barakat's USA Today article on floaters says that almost everyone has or will develop floaters at some point in adult life, especially with old age and near-sightedness. The shapes and sizes of floaters differ, from tiny "fuzzball" specks in one's vision that go away after a short time, to more intense and lasting cases that Virginian surgeon Dr. John R. Karickhoff, (who contributed to Barakat's report and published his own report on floaters for Ocular Surgery News) compares to holding a pencil point closely in front the eyeball while trying to read. For some people, this can ruin the quality of life.

  Floaters are usually just harmless bits of membrane dislodged from other parts of the eye, a condition that will usually cure itself with time. Dr. Karickhoff estimates that 95 percent of floaters cases should be left alone, but that 5 percent of people with floaters have a legitimate problem that requires treatment.

YAG Laser Treatment

• The type of laser treatment used to treat floaters is the Yttrium-Aluminum Garnet (YAG) laser. The YAG precision laser technology targets the floater with pinpoint zaps that may work in a few ways, depending on the type of floater. Either the laser beam transforms the floater into a gas and obliterates it with vaporization, relocates the floater outside of the visual axis, or thins the floater, if it is slightly outside of the visual axis.

Advantages

• In the past, the only medical treatment (aside from herbal treatments touted as effective for reducing floaters) to get rid of floaters was vitrectomy, which involves making surgical incisions into the eye. This procedure poses high risk for cataract formation and other complications, according to Dr. Karickhoff, who says that YAG laser treatment is much safer and more cost-effective than vitrectomy. Other advantages of YAG laser treatment include the rapidity of the procedure, which is performed in 20 minutes under local anesthesia, and the treatment removes only the floater, without removing or affecting the vitreous gel. Recovery time is less than 24 hours. Dr.Karickhoff also says that insurance may cover the procedure.

Effectiveness

• All patients who described their experiences for Barakat's USA Today article on laser treatment for floaters said that the procedure was a success, free of complications and side effects.

  Dr. Karickhoff has performed the laser treatment procedure on more than 1,400 patients with floater conditions over the past 15 years and claims that it has been effective in 92 percent of the cases, with minimal risks and complications; in the unsuccessful cases, there was no harm done, and vision was not reduced. Dr. Karickhoff has written a medical book about laser treatment for floaters, which he says received positive feedback from the American Academy of Ophthalmology. Chief of Ophthalmology at Inova Fairfax Hospital, Dr. Manfred von Fricken, says that he has seen Dr. Karickhoff's patients who have indeed benefited from the surgery.

Misconceptions

• Overall, the medical world is still skeptical about the use of YAG laser treatment for floaters, and some ophthalmologists still believe it can produce retinal detachments. Dr. Karickhoff claims that out of the 3,000+ procedures he's witnessed, not one has produced a retinal detachment, including 48 cases in which patients had already had treatment for retinal tears or detachment. The aforementioned article for Ocular Surgery News says that another misconception is that doctors assume that the laser simply breaks the floater into pieces, when, in fact, it is powerful enough to transform it into a gas and obliterate it. Dr. Karickhoff also says that doctors often underestimate the severity of floater conditions and erroneously assume that all floaters will go away over time, which, he says is not true in all cases.