Surgical management of symptomatic vitreous floaters.

Vitreous floaters are common. Most every ophthalmologist treating adults sees new and existing patients with a chief complaint of floaters in the office on a daily basis. Yet, treatment options for bothersome floaters have traditionally been quite limited. Robert Machemer introduced pars plana vitrectomy (PPV) in the early 1970s, and with the progressively decreasing gauge size, the idea of PPV for floaters has become a hot topic of conversation. Of the 683 respondents from the U.S. and Canada in the 2013 American Society of Retina Specialists Preferences and Trends Survey, 69% report performing PPV for vitreous opacities. Results were similar in 2012, when the question was first asked in the survey. The survey does not ask the gauge used or the frequency this procedure is performed for floaters. In the June edition of the journal Retina, Sebag et al1 and Mason et al2 describe using 25-gauge sutureless PPV for the treatment of visually impacting vitreous floaters. Both sets of authors identify posterior vitreous detachment (PVD) as the most common cause of floaters, while other causes include vitreous syneresis, asteroid hyalosis, and myopic vitreopathy. In both articles, the authors demonstrate favorable outcomes with their surgical interventions. Sebag et al present a two-part study consisting of a prospective efficacy analysis and a retrospective safety profile. The study Surgical management of symptomatic vitreous floaters