Laser vitreolysis uses a Neodymium: Yttrium-Aluminum Garnet (Nd: YAG) laser to achieve “optical breakdown” and to vaporize floaters within the eye.
Laser vitreolysis is covered by medicare and most private insurance companies (subject to prior approval for private insurance)
The YAG laser is commonly used in other eye procedures including posterior capsule opacification and peripheral iridotomy. For those common treatments the laser is used to disrupt tissue, however if these settings are used for vitreolysis the floater will be fragmented into small pieces. Therefore in vitreolysis the laser is set slightly higher.
After dilating their pupil, a numbing eye drop is given to the patient and a special contact lens for treating eye floaters is placed on their eye. Then the laser is carefully aimed and either the floater itself or its attachments are vaporized so that the floater is repositioned to a different part of the eye. This disruption also helps the eye to absorb any remaining particles.
The disruption is carried out with a beam of invisible light through the pupil. There is no incision or discomfort. Depending on the type and number of floaters, the procedure may take as little as 5 minutes or up to half an hour. Postoperatively there are no restrictions on activities.
Laser vitreolysis is generally considered to be safer than a classic, surgical vitrectomy since it is less invasive. The success of laser treatment very much depends on the type of floaters and their position. Dr Scott Geller writes that some patients, predominantly those under the age of 35, cannot be treated (for floaters) as the floaters may be too close to the retina in an area referred to as the ‘pre-macula bursa’ (the consequence of which is that the floater is more dominant in the patients view, its size exaggerated as a result of the distance to the retina). However success rates are excellent in older patients with few isolated floaters.