Floaters and Vitrectomy: Knowledge From Large Review

Floaters—those gray, dark or hazy spots, threads, or cobwebs that drift in your vision—are small clumps of collagen inside the vitreous gel that fills the eye. While common and usually harmless, they can be very disruptive for some people. These persistent floaters can impair daily activities like reading, driving, and using a computer. Fortunately, many patients have found floater relief with vitrectomy surgery.

Vitrectomy, also called pars plana vitrectomy (PPV), is a microsurgical procedure where a retinal surgeon removes the vitreous gel from the eye and replaces it with a clear fluid. This technique is commonly used to treat retinal problems such as retinal detachment or hemorrhage in the vitreous, and it may also be performed to remove symptomatic floaters—a procedure sometimes called floaterectomy. In the past, many eye doctors considered surgery for floaters too risky, but new studies are challenging that belief.

A systematic review and meta-analysis in Ophthalmology and Therapy (Dysager et al, 2022) evaluated 12 databases of patients who had had vitrectomy for floaters with at least 3 months of follow-up. Twelve studies were identified and a total of 2077 eyes of 1789 patients revealed that patient satisfaction was high (90%) and contrast sensitivity (our ability to see in dim lighting) improved. The risks of complications were low: retinal tears, vitreous hemorrhage, macular edema, retinal detachment and glaucoma occurred in less than 2%. Serious infection (endophthalmitis) occurred in less than 1%. Therefore, vitrectomy surgery for floaters in experienced hands is a safe procedure.

In summary, vitrectomy for floaters is a valid, effective, and low-risk treatment for the right patients. Floaters are not “just in your head.” They are real, visual obstructions that can be safely treated. While not every person with floaters needs surgery, for those with dense, persistent floaters that interfere with daily life, floaterectomy can be life-changing. As surgical tools and techniques improve, and as awareness grows, more patients may get the relief they need.