HOW LONG DOES TREATMENT EFFECT LAST?

Occasionally I am asked about how long a treatment lasts or some similar sentiment. As with any fair answer to a medical question, it should begin with “It depends…”

Everyone who has sat in the exam chair in my office comes to me with a unique sets of variables: Different types of floasters, amounts, distribution and location, amount of movement of floaters due to liquifaction, as well as important variables in the optics of the eye (previous refractive surgery, cataract surgery, pupil size, etc.).

There is a limited amount of protein available in the eye to aggregate and form the protein densities that are the floaters in your eye. You do not replenish or replace them. It is a fixed amount. That said, there is a wide variety in how it presents to me. Simply, some types of floaters are more desireable to treat than others, in part, because they are more efficient to treat requiring less overall laser energy and/or treatment sessions.

Ultimately, my goal with the laser is to vaporize the proteins and convert them to microscopic gas bubbles where they will dissolve and go away forever. Other, less desireable types of floaters, the diffuse and cloudy types are much less efficiently treated, and have the pesky tendency to reform, although reforming to a smaller floater. That reformed floater will then require treatment. Treating these cloudy floaters feels like taking a journey of “3-4 stpes forward, and 1-2 steps backwards”. It can be frustrating, but as they say in software programming, “it is not a bug, but a feature”.

It is not unusual to still have pretty good initial treatment results with these difficult-to-treat floaters (e.g. 60-75% improved) and then see the same patient back in 3-12 months for some continued clean up attempts. This introduces my version of the Pareto Principle wherein it feels like I spend 80% of my time at the laser trying to clean up that last 20% of the floater problem.

This is not a simple answer to the question “How long does treatment last”, but it is a more complex explanation to a complex and HIGHLY VARIABLE problem where it is difficult to make concrete predictions. There are some types of floaters (e.g. Weiss Ring types) that are by definition a one-time event. After using the laser to obliterate that material it can not return and there are no more Weiss rings in the eye. These are my favorite to treat.

What do you have? I don’t know. Ultimately it takes an in-person evaluation to determine that with more confidence. Also, I have not found the chart notes from your local eye care provider to be very helpful in this regard.

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