Vitreolysis is a non-invasive laser treatment designed to address specific visual disturbances within the eye. This procedure uses targeted laser energy to break up or vaporize vitreous opacities, commonly known as eye floaters. Its primary goal is to improve a patient’s functional vision by reducing the hindrance caused by these floaters.
Understanding Vitreous Floaters and Flashes
The eye’s interior contains a clear, jelly-like substance called the vitreous humor. As people age, this vitreous can undergo changes, becoming more liquid and less firm. Within this aging vitreous, strands of a protein called collagen can become visible, clumping together to form small specks, dots, lines, or cobweb-like shapes that drift across a person’s vision. These are known as eye floaters, and they cast shadows onto the retina, the light-sensitive layer at the back of the eye, which the brain then perceives.
Flashes, also called photopsias, occur when the shrinking vitreous gel pulls or rubs on the retina. This mechanical stimulation creates flashing lights or lightning streaks. While floaters and flashes are often benign, commonly stemming from a natural age-related process called posterior vitreous detachment (PVD), a sudden increase in their number or intensity can sometimes signal more serious conditions like retinal tears or detachment, which require prompt medical attention.
The Vitreolysis Procedure
Vitreolysis is performed as an outpatient procedure. Before treatment, anesthetic eye drops are administered for patient comfort. A specialized contact lens is then placed on the eye, allowing the laser light to be delivered through a microscope.
This procedure employs a Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser, which emits nanosecond pulses of low-energy laser light. The laser is precisely aimed at the vitreous opacities. The focused laser energy vaporizes the collagen and hyaluronin molecules within the floater into a gas. This process either breaks the floater into smaller, less noticeable pieces or eliminates it entirely. During the 10 to 45-minute procedure, patients may observe gas bubbles that quickly dissolve and are reabsorbed by the vitreous.
What to Expect After Vitreolysis
Following a vitreolysis session, patients may experience mild eye redness or discomfort, which is manageable with over-the-counter pain relief. Anti-inflammatory eye drops may also be prescribed for a few days after the procedure. It is normal to initially perceive more floaters immediately after treatment; these are small gas bubbles formed from the vaporized floaters and will gradually dissipate over the following weeks as they are absorbed into the eye’s gel.
Most patients report a significant reduction in their floater symptoms, with an average improvement ranging from 60% to 90%. Multiple treatment sessions, two to three, may be necessary to achieve optimal results, with sessions often spaced about four weeks apart. While vitreolysis is considered safe, rare complications can occur, including temporary or prolonged elevation of intraocular pressure, which can sometimes lead to glaucoma, or the formation of focal cataracts. Retinal tears or detachments and retinal hemorrhages have also been reported, though these are uncommon.