We describe our experience of ten cases of posterior segment vitreolysis, using the short-pulse
neodymium YAG (
Yttrium Aluminium Garnate)
laser. Eight patients had proliferative
diabetic retinopathy, one patient had had an intraocular
foreign body removed and one patient had had
uveitis. Of the ten, five patients had macular
traction retinal detachments, three patients had progressive
traction retinal detachments threatening the macula and two patients had recurrent vitreous haemorrhages from mechanical
traction on areas of fibrovascular proliferation. Eight of the patients were successfully treated. One macular
retinal detachment failed to flatten and a tear was found which may have been iatrogenic. In one patient with a
traction retinal detachment significant
traction was relieved but the detachment failed to flatten completely. We discuss the indications, techniques, difficulties and complications. Our experience suggests that this technique has an important role in the treatment of selected patients, sparing patients conventional
vitrectomy, or making possible the treatment of those for whom
vitrectomy has been contraindicated or refused. Anterior defocusing of the YAG would be a useful modification of current
laser systems and improved aiming systems desirable for the future.