PURPOSE Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser treatment is performed on vitreous floaters, but studies of structural and functional effects with objective outcome measures are lacking. This study evaluated Nd:YAG laser effects by comparing participants with vitreous floaters who previously underwent laser treatment with untreated control participants and healthy persons without vitreous floaters using quantitative ultrasonography to evaluate vitreous structure and by measuring visual acuity and contrast sensitivity function to assess vision. DESIGN Retrospective, comparative study. PARTICIPANTS One eye was enrolled for each of 132 participants: 35 control participants without vitreous floaters, 59 participants with untreated vitreous floaters, and 38 participants with vitreous floaters previously Nd:YAG-treated. Of these, 25 were dissatisfied and sought vitrectomy; 13 were satisfied with observation. METHODS The 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-39) to assess participant visual well-being, quantitative ultrasonography (QUS) to measure vitreous echodensity, and best-corrected visual acuity (BCVA) and contrast sensitivity function (CSF) to evaluate vision. MAIN OUTCOME MEASURES Results of NEI-VFQ-39, QUS, BCVA, and CSF. RESULTS Compared with control participants without vitreous floaters, participants with untreated vitreous floaters showed worse NEI-VFQ-39 results, 57% greater vitreous echodensity, and significant (130%) CSF degradation (P < 0.001 for each). Compared with untreated eyes with vitreous floaters, Nd:YAG-treated eyes had 23% less vitreous echodensity (P < 0.001), but no differences in NEI-VFQ-39 (P = 0.51), BCVA (P = 0.42), and CSF (P = 0.17) results. Of 38 participants with vitreous floaters who previously were treated with Nd:YAG, 25 were dissatisfied and seeking vitrectomy, whereas 13 were satisfied with observation. Participants seeking vitrectomy showed 24% greater vitreous echodensity (P = 0.018) and 52% worse CSF (P = 0.006). Multivariate linear regression models confirmed these findings. CONCLUSIONS As a group, participants previously treated with Nd:YAG laser for bothersome vitreous floaters showed less dense vitreous, but similar visual function as untreated control participants with vitreous floaters. Because some treated eyes showed less dense vitreous and better visual function than those of untreated control participants, a prospective randomized study of Nd:YAG laser treatment of vitreous is warranted, using uniform laser treatment parameters and objective quantitative outcome measures.

中文翻译：

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钕：钇铝石榴石激光玻璃体溶解后玻璃体结构和视觉功能的评估。

目的对玻璃浮子进行钕：钇铝石榴石（Nd：YAG）激光治疗，但是缺乏对结构和功能效应的客观研究。这项研究通过比较先前曾接受过激光治疗的玻璃体漂浮物的参与者与未经治疗的对照参与者以及没有玻璃体漂浮物的健康人进行的Nd：YAG激光效果评估，使用定量超声检查来评估玻璃体结构，并通过测量视敏度和对比敏感度功能来评估视力。设计回顾性比较研究。参与者132名参与者中的每只参与者都被征入了一只眼睛：35名没有玻璃体漂浮物的对照参与者，59名未经治疗的玻璃体漂浮物的参与者和38名经过Nd：YAG治疗的玻璃体漂浮物的参与者。这些，25例不满意并寻求玻璃体切除术；13人对观察表示满意。方法39项国家眼科研究所视觉功能问卷（NEI-VFQ-39）用于评估参与者的视觉健康状况，定量超声（QUS）以测量玻璃体回声密度，最佳矫正视力（BCVA）和对比敏感度功能（ CSF）以评估视力。主要观察指标NEI-VFQ-39，QUS，BCVA和CSF的结果。结果与未使用玻璃体漂浮物的对照组相比，未处理玻璃体漂浮物的参与者显示出较差的NEI-VFQ-39结果，玻璃体回声密度增加了57％，并且CSF降解显着（130％）（每个P <0.001）。与未经治疗的玻璃体漂浮物眼相比，经Nd：YAG治疗的眼睛的玻璃体回声密度降低了23％（P <0.001），但NEI-VFQ-39的差异无统计学意义（P = 0.51），结果是BCVA（P = 0.42）和CSF（P = 0.17）。在先前曾接受过Nd：YAG治疗的38例玻璃体漂浮物参与者中，有25例不满意并寻求玻璃体切除术，而13例对观察结果满意。寻求玻璃体切除术的参与者显示出玻璃体回声密度高24％（P = 0.018）和CSF较差52％（P = 0.006）。多元线性回归模型证实了这些发现。结论作为一个小组，先前用Nd：YAG激光治疗过麻烦的玻璃体漂浮物的参与者玻璃体密度较低，但视觉功能与未治疗的玻璃体漂浮物的对照组参与者相似。由于某些接受治疗的眼睛比未接受治疗的对照组参与者的玻璃体密度更低，并且视觉功能更好，因此有必要对Nd：YAG激光治疗玻璃体进行前瞻性随机研究，