Interventional procedure overview of YAG laser vitreolysis for symptomatic vitreous floaters

Studies were conducted in Brazil (n=3), US (n=2), China (n=2) and Spain (n=1). No data were collected in the UK.

There was some patient overlap between 2 studies (Shah 2017, 2020). However, the total sample of 255 patients was derived from removing duplications.

Of the 8 studies, 7 studies described follow-up periods, with most studies (n=5) reporting 6-month outcomes.

There was variation in patient inclusion criteria (such as types of floaters) and procedure technique (such as laser energy delivered, number of sessions, and durations between sessions) between studies. Most studies required patients to have symptoms for at least 6 months.

When reported, in most patients 1 eye was treated and a single session was done.

Two randomised controlled trials were included, with 1 trial being adequately powered and of good methodological quality.

Both randomised controlled trials compared YAG laser vitreolysis with sham YAG laser vitreolysis. There might be a placebo effect on some subjective improvement in the sham group by the stimulated procedure.

There were different devices used for this procedure. It was unclear whether all these devices were licensed for vitreolysis.

Floaters can reduce with time, although most studies required that floaters had been present for at least 6 months, so resolution might be less likely by that stage. Nonetheless, the lack of a control group in some studies makes it difficult to distinguish a treatment effect from natural history.