A vitrectomy is the basic operation used by a retina specialist for treatment of blood, epiretinal membranes, macular holes, retinal detachments and…floaters.
There is no difference between a vitrectomy for floaters (FOV) and a vitrectomy for removal of blood, macular pucker, etc. In all cases, the vitreous must be removed to allow me to safely operate on the retina.
In the case of the FOV, once the vitreous is removed (and the floaters), the operation is complete. In a way, it’s a partial operation.
I use this type of system almost exclusively. The “25 gauge” instrumentation requires small ports, or holes, to be made for passage of the instruments into the eye. While this does dramatically reduce the operating time, it also significantly speeds the healing process as there is much less cutting on the ocular tissues.
The holes are self-sealing and do not require stitches.
The instrument, a vitrector, rapidly “sucks and cuts” the vitreous hundreds of times/minute. The vitreous is adherent to the retina. Pulling on the vitreous could cause a retinal tear and then a retinal detachment.
This rapid succession of “sucking” and cutting makes it almost impossible to pull on the retina.
In many cases, the protein makeup of the vitreous has changed and the floaters, seen commonly as dark dots, move “to and fro” within the eye. The vitreous is the only area in the eye where objects can move in this fashion.
FOV is the most viable treatment for floaters. I recommend surgery if the opacities are bothersome, move to and fro and you understand the risks of surgery. I prefer the floaters to have been present for several months. After this time, they are unlikely to go away.
I do not perform laser for floaters and am not aware of any retina specialists who do. I recommend against laser treatment as I believe the risks are too high for causing tears in the retina.
I’ve been asked by several followers to publish such a video. I thank “floateredeyes” for his patience in gently reminding me to get this done.
The movie was recorded directly from the operating microscope onto my laptop. We used ONLY iMovie (the program and background sound).
What Does this Mean?
There are a significant number of patients suffering from floaters. Too often, these patients are scolded and advised to “get used to them.” Vitrectomy surgery is as safe, or safer, than cataract surgery and can be a viable option and life-changing.
Just as others want and need cataract surgery to improve vision, patients plagued with floaters can be helped.