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Yes. Ophthalmic YAG Lasers have been around for 20 years. There is an established Insurance CPT code associated with Laser Vitreolysis. Most insurance plans will partly or mostly pay for the procedure with the appropriate documentation. Virtually every ophthalmologist has used the YAG laser to accurately break up membranes and or vitreous material.

The Lasers used to treat floaters are FDA approved for use in the eye. In 2002 Dr. John Karickhoff submitted a document to the FDA outlining the current understanding of the laser physics, the past published studies as well as a summary of his years of experience with the procedure of treating floaters with the laser . The FDA had ruled that his  proposed study of laser treatment of vitreous opacities was a non-significant risk device study.  They further ruled that a special device exemption from the FDA to use a YAG laser in the study was not required. As such, the use of the YAG laser to treat vitreous floaters is still considered an off label use of the laser, and it is up to the individual surgeon to determine the appropriateness of its application.

We can't answer for others, but we know that there seems to be little interest in this benign, non-pathological condition. No pharmaceutical companies can benefit, and the manufacturers already have their lasers FDA approved. We think that in general eye doctors have not really been listening to their patients when they have visually-significant or dense floaters. In general, once your eye doctor has determined the absence of retinal detachment or other serious pathology,they try to reassure you or minimize the concern and then move on to their next challenge. Another factor is that it is not easy to do. We are aware of other doctors who have tried to treat floaters, but maybe didn't has the appropriate lenses, or used inappropriate energy settings and became frustrated with the apparent failure and gave up on the procedure. It takes tens of thousands of laser shots to develop the skill set to treat floaters. It also takes a real commitment of the part of the physician to be willing to sometimes spend 30-45 minutes looking for some small, sometimes almost impossible to find floater. Sometimes after all of that, we may not even be able to treat because it is too close to the retina

Alright, here's the technical details...The YAG laser emits the beam in a cone-shaped pattern. At the apex (or tip) of the cone there is a concentration of the energy. Using focusing lights, this apex is directed onto the front surface of the floater material. The laser  "shot" lasts only 20-30 nanoseconds (0.000000030 seconds), and at that moment the concentrated laser light creates a small plasma-state "bubble". As you all will remember from your physics courses, plasma is the fourth state of matter, (the first three being solids, liquids, and gas). Matter that has been converted to plasma has the electrons pulled away from their usual location and creates a high energy state of the matter. This process actually converts the floater material to a micro-gas bubble that floats away. It is important to understand that the laser does not just break the floater into small pieces, but actually changes it to a gas. The gas is reabsorbed into the bloodstream over the course of a few hours. There is a better and more detailed explanation HERE

Every eye is different and there are too many variables to list here, but it is reasonable to expect 60-90% improvement and decrease in the mass or amount of the floaters. Most patients will need a second (and rarely a third or more) treatment to clear up most of the rest. There have been a few patients ( about 15% of consultations) that have such thin, transparent floaters (or too close to the retina) that we haven't even able to see them or treat them.

Time, location, and total energy. In addition, floaters that are too close to the retina or lens may not be safely treated. During the treatment, we monitor the energy of each shot, as well as the total energy used during the treatment and keep it within an empirically determined range.

We have an entire page that goes into great detail on this topic HERE. We believe that in the hands of an experienced laser surgeon it is a relatively low risk and very well tolerated procedure. Previous published studies have confirmed this. Since the laser delivers physical energy, it is crucial to maintain a safe distance away from the critical lens and retina structures. We have had a couple patients respond with elevated eye pressures that had to be treated with eye drops to lower the pressure. No one has ever had a retinal detachment from this procedure, and no-one has lost visual acuity due to retinal injury.

There is a head strap on the laser that firmly holds the head in place. In addition, the hand-held contact lens stabilizes the eye quite well. The combination allows me to focus on objects that are very small (fibrous strands < 1/20 of a millimeter) with great accuracy. Although we have mild sedatives available, we have only used them once, and afterwards the patient suggested he probably didn't need it after all. Even very nervous patients will agree afterwards that it is a very tolerable, painless, procedure.

With few exceptions, every patient that we have treated has described about a 60-90 percent improvement. Most patients will need a second (and rarely a third or more) treatment to get to that endpoint. There have been a few patients ( about 15% of consultations) that have such thin, transparent floaters (or too close to the retina) that Dr. Johnson wasn't even able to see it or treat it.

FEES: The details of the fees are described in detail HERE. To summarize, there is a one-time initial evaluation/consultation fee of $195. The is a fee of $1418 for the first treatment of either eye. Any second or subsequent  treatment in the same eye is $180 per eye per session. There is a "cash" discount of 7% for cash or personal checks. We accept VISA, MC, and AMEX.

INSURANCE REIMBURSEMENT: We request payment at the time of service and do not accept direct assignment payment from medical insurance carriers. We will provide documentation for you to submit to your medical insurance carrier for reimbursement.

Most of the time after there is not an improvement in Snellen Chart visual acuity. This is the testing that most are familiar with: small, high-contrast letters 20 or so feet away. This vision is usually noted as 20/20 or 20/something in the US. This only tests the central (albeit most important) visual acuity. There are other aspects of vision such as contrast sensitivity, color, peripheral, and a vague and harder to quantify "quality of vision". For instance, you could have 20/15 vision by the chart. Excellent vision, right? But what if you have advanced glaucoma with tunnel vision? Or in the case of floaters, what if you have swirling soup moving about with every eye movement. It may be 20/15, but who cares if you have that junk moving around in your eye.
Occasionally there is a dense, stable floater stuck right in the middle of the visual axis. With treatment we have seen improvements of up to four lines of vision after a series of treatments. That situation is rare, though, and I never give a patient that expectation. More often the floater will drift through the central axis temporarily blurring the vision in that eye.
The optics of the eye don't change with treatment. The corrective spectacle prescription is a function of the corneal curvature, the strength of the crystalline lens and the length of the eye which are not affected by laser treatment for floaters.

This is an anatomical space, actually a "potential space". We believe that there might be some cellular debris or other microscopic bits that are trapped in this space. They are seen as moving shadows only because they are so close to the retina. The eye doctor cannot see this space or the "debris", but it is the only explanation for the floater-like moving shadows that young people see but are not part of the vitreous humor degeneration we see as people get older. The premacular bursa is an issue mostly in young people in their teens and twenties with floater-like symptoms. These "floaters" are generally not treatable.

Yes, but with some difficulty, otherwise no dramatic changes in technique. The difficulty with post-laser refractive surgery eyes is that there is a central area of the cornea (approx 8-9mm) that has been reshaped, then a surrounding "transition zone" of about 1mm, then the peripheral, untouched cornea. When you shine the ophthalmoscope into the eye and see the "cat's eye" light reflex, there appears to be a lens within a lens or a "button" of different optical quality. Even if the pupil is a larger 10-11 mm, the effective working diameter is only that 8mm. When every millimeter of pupil dilation matters, This essentially restricts the coherent, organized focus of the laser. The bottom line is that the efficiency of the laser can drop way down. Sometimes as little as 1 in 5 shots may be actually affecting the floater.
Other times in LASIK patients, the laser is fully efficient and you'd never know the difference. I can't tell beforehand. The difficulty is likely related to the amount of correction, and the distance to the floater treated.

As far as measuring distances, you would think we would be using some device like ultrasound or similar to get an accurate measurement of distances. We have an ultrasound device but rarely use it as the fine or small floaters just don't show up well and their position is often very dynamic and changing. There are a few clues we use at the treatment laser to get a good accurate estimate of the distances: first is a very narrow depth of field using the biomicroscope. When we am focusing on an object, nearly everything is blurry anterior and posterior to that focus. If the background is a diffuse blurry orange then we know the focus is plenty far from the retina. As the laser is focused further back and the retinal detail becomes more distinguishable, then we know we am approaching the retina. We can then rely more on binocular depth perception and the shadows cast onto the retina by the floater to aid is distance estimation. In addition there are two red laser focusing beams that are 16 degrees apart. Those have to be coincidental on the surface of the floater. These beam diverge again on the far side of the focal point. The further and blurrier these beams are then the farther the focus is from the retina. Another factor is experience. Our laser shot count is over 500,000 shot fired at floaters so there is just a subconscious awareness of where I am. These are just a few factors that come with experience and I have thought how hard it would be to teach this procedure to other doctors. If you considering treatment, make sure the doctor as the experience of hundreds of thousand of individually aimed, assessed, and fired laser shots.

The studies you referenced are also available as full PDF downloads from the web site HERE.
If you scratch beneath the surface and know what to look for there are some important considerations that help explain why they had a relatively low success rate (about 30%, but didn't define what success was). They can be categorized into 1). Energy levels, and 2). Strategy/technique.
1. ENERGY: The lasers are FDA approved for delivering energy to intraocular structures, specifically the posterior lens capsule. The lens capsule will often opacify making a successful cataract surgery seem to backslide. The laser is fired through a thin, clear implant lens directly at the capsule. The nominal energy level listed on the laser is often in the 2-4 mJoule range. This is the energy range that the doctors are used to using. When aiming further back into the vitreous space, the laser is fired through a thick treatment contact lens, a thicker biological crystalline lens, and deeper into the vitreous. The laser can be partially blocked by the iris, and the focus and concentration of the laser energy is diminished when firing even slightly off the central visual axis. The result is that the laser energy must be set higher to compensate for these factors. These referenced studies used low energy levels which I were inadequate to achieve the quantum bump in energy to get the vaporization of tissue.
2. TECHNIQUE: British study describe their technique and approach to try to disrupt the posterior hyaloid face and and attempt to sever the suspensory strands that hold the floater in place. They were primarily trying to move the floater out of the way instead of actually vaporize the floater material. I have very rarely seen the opportunity where either of these techniques worked very well.

With these considerations, I'm actually surprised they got even a 30% success / satisfaction rate.

Next, we will discuss the potential risks of the laser vitreolysis procedure HERE.