Vitrectomy for vitreous floaters

Summary Symptomatic vitreous ‘floaters’ are one of the most common presenting complaints in the clinics of ophthalmologists. Although most patients will accept observation as the symptoms often improve spontaneously, in a subset of patients the symptomatic, persistent vitreous opacifications do not disappear with time and may become highly bothersome in daily life. During the past two decades, more and more patients have been treated for persistent floaters. Pars plana vitrectomy (PPV) and Nd:YAG laser photodisruption have been considered. Since Robert Machemer introduced PPV in the early 1970s, and with the progressively decreasing gauge size, the idea of using this surgical technique for vitreous opacities has become a hot topic in the ophthalmologic community. PPV is the gold standard for mechanical removal of vitreous opacities. The so called ‘floaterectomy’ shows resolution of vitreous opacities in over 95% of cases and patient satisfaction rates range from 85 to 94%, with improvement in contrast sensitivity and quality of life. Microincisional vitrectomy surgery (MIVS) has been shown to decrease operative times, surgically induced trauma and postoperative inflammation, leading to a more rapid recovery and in a more safety manner.