Name:
Laser Treatment of Eye Floaters
Author:
Book Size:
232 Pages
Illustrations:
137
Publisher:
Washington Medical Publishing, LLC
Copyright Date:
2005
Language:
English US
ISBN-10:
0976897210
ISBN-13:
978-0976897217
Cost:
$225.00 U.S.

Overview

Introduction

  • Eye floaters and present treatment options
Pages: 13-17

Chapter 1: The Vitreous, Floater Formation, Floater Types, and Clinical Course

  • The vitreous...18
  • Floater formation...18
  • Floater types...20
  • Course of Floaters...22
Pages: 18-22

Chapter 2: Floater Treatment Options

  • Do nothing ("Learn to live with it.")...23
  • "Sunglasses"...23
  • "Herbal/medical"...24
  • Vitrectomy...25
  • Laser treatment...28
  • Why laser treatment is unknown...28
Pages: 18-22

Section: Clinical History and Examination for Laser Treatment

Chapter 3: Symptoms, Floater History, Justification for Treatment

  • Symptoms...31
  • Four factors in symptoms...31
  • Karickhoff symptom severity formula...32
  • Incorrect assumptions...33
  • Patients see what doctors can not...33
  • Floaters affect visual acuity...34
  • History...34
  • Justification for treatment...34
Pages: 31-34

Chapter 4: The Floater Examination

  • Pertinent data...36
  • The order...36
  • Karickhoff "Floater Finder"...37
  • Direct ophthalmoscope...37
  • Indirect ophthalmoscope...38
  • Contact lens...39
  • Hruby lens...39
  • +90 diopter hand held lens...39
  • Locating a floater with the Karickhoff Patient Assisted method...40
  • Macular test...41
  • Demonstrating the floater to the patient (Karickhoff method, commercial method)...42
Pages: 36-43

Chapter 5: History of Ocular YAG Lasers

  • Early history...44
  • Development of mode-locked (picosecond) YAG lasers...45
  • Development of Q-switched (nanosecond) YAG lasers...45
Pages: 44-47

Chapter 6: Simplified Explanation of Floater Vaporization

  • Using vaporization and obliteration...48
  • Optical breakdown and plasma formation...48
  • Similarity to a lightning strike...48
  • Conversion to a gas...49
Pages: 48-49

Chapter 7: Laser Physics of Floater Obliteration

  • How a laser works...50
  • Optical break-down in eye surgery...51
  • Plasma shields...52
  • Fundamental vs. the multimode operation...53
  • Continuous vs. pulsed emission...53
  • Nanosecond vs. picosecond lasers...54
  • Q-switching vs. mode-locking...54
  • Vaporization without burning...57
Pages: 50-59

Chapter 8: Laser Optics for Floater Treatment

  • Proper illumination...60
  • Aiming beams...61
  • Converging treatment beam...61
Pages: 60-61

Section: Clinical Studies of Floater Laser Treatment

Chapter 9: Informal Studies

  • Tsai...62
  • Geller...62
  • Delaney...62
  • Karickhoff...62
Pages: 62-63

Chapter 10: Our Formal Study Of 200 Consecutive Eligible Floater Cases

  • Done under the guidelines of the U.S. Food and Drug Administration and supervised by our hospital Institutional Review Board...64
  • Inclusion and exclusion criteria...65
  • The procedure...66
  • Monitoring procedures and statistical methods...66
  • Conclusions...68
  • Deficiencies of the Study...70
Pages: 64-70

Section: Benefits Risks Criteria Of Success

Chapter 11: Benefits Success And Risks Of The Procedure

  • 92 per cent overall...71
  • Case selection...71
  • Two basic approaches to achieve success...71
  • Vision frequently improved one to three lines...71
  • Low risk procedure...71
Pages: 71-72

Section: Selecting Patients

Chapter 12: Surgical Indications And Contraindications

  • Indications...73
  • Contraindications...74
  • Relative contraindications (only good eye)...76
Pages: 73-76

Chapter 13: Young Patients With Floaters

  • Transparent threads...77
  • Syneresis clouds...77
  • Fibrin strands...77
  • Finding the floater...78
  • Karickhoff Patient Assisted Method...79
Pages: 77-79

Section: The Procedure

Chapter 14: The Procedure And Discussion Of It Before During And After

  • Discussing the vitreous face...80
  • Discussing multiple floaters...80
  • Discussing gas bubbles...81
  • Evaluation and procedure plan...81
  • Which eye first...81
  • The procedure...82
  • Post-operative instructions...83
Pages: 80-83

Chapter 15: How Other Eye Structures Affect The Procedure

  • Cornea (RK and LASIK)...84
  • The lens...85
  • Small posterior capsulotomy...85
  • Contracted anterior capsule...86
  • Cataract...86
  • Intraocular lens...87
  • Multifocal intraocular lens...87
  • Intraocular contact lens...88
  • Floaters near the lens...88
  • Iris...88
  • Floaters near the retina...89
  • Vitreous...89
Pages: 84-90

Chapter 16: Treatment General Concepts 20 Floater Types And Techniques

  • General concepts...91
  • Obtaining optical breakdown...94
  • Non-fibrous floaters...95
  • Fibrous floaters...96
  • Weiss rings...97
  • 16 techniques for Weiss rings...104
  • Very small floaters...108
  • Fan-shaped floaters...108
  • Peripheral floaters...109
  • Syneresis floaters...110
  • Non-suspended syneresis floaters...110
  • Suspended syneresis floaters...111
  • Syneresis cloud hidden below...112
  • Weiss ring-syneresis cloud combination ("Floater Duet")...113
  • Tiny, white 114
  • Floaters from retinal cryopexy and the argon laser...114
  • Floaters in high myopia...115
  • Laser floater treatment following vitrectomy...115
  • Asteroid hyalosis treatment...115
Pages: 91-115

Chapter 17: Technical Difficulties

  • Aiming problems...116
  • Difficulty seeing the floater...116
  • Losing the floater...116
  • Low brow...117
Pages: 116-117

Section: Safety And Avoiding Complications

Chapter 18: The U S Food And Drug Administration And Floaters

  • Dr. Karickhoff's application and approval...118
  • FDA policy...119
Pages: 118-119

Chapter 19: Retinal Protection

  • Historical lack of retinal detachments...120
  • Eight ways the retina is protected...120
Pages: 120-121

Chapter 20: Avoiding Complications

  • General lack of complications...122
  • General rules...122
  • Preventing pain...123
  • Preventing corneal complications...123
  • Preventing contact lens problems...124
  • Preventing gonio fluid complications...125
  • Preventing elevated pressure...125
  • Preventing retinal damage...129
  • Preventing retinal hemorrhage...131
  • Preventing macular damage...134
  • Absence of retinal detachments...134
  • Preventing cataract formation...135
  • No accelerated vitreous degeneration...136
Pages: 122-136

Chapter 21: Follow Up Retreatment

  • Examination immediately after treatment...137
  • Examination the day after treatment...137
  • Re-treatments...138
  • Follow up examinations...138
Pages: 137-138

Section: Equipment

Chapter 22: Selection Of A Laser

Pages: 139-149

Chapter 23: Selection Of Diagnostic And Surgical Contact Lenses Designing A Surgical Contact Lens

  • Diagnostic contact lenses...149
  • Karickhoff Laser lens...149
  • Fundus Laser Lens...149
  • General concepts of treatment lenses...150
  • Seven treatment lenses...151
  • Karickhoff 21 mm. lens...151
  • Karickhoff Off-Axis lens...152
  • Peyman 12, 18, and 25 mm. lenses...153
  • Lasag CGV lens...154
  • Abraham posterior capsulotomy lens...155
  • Abraham iridotomy lens...156
  • Designing a surgical contact lens...157
Pages: 149-158

Chapter 24: Selecting Making Diluting Gonioscopic Fluid

  • Problems with gonioscopic fluids...159
  • Methylcellulose vs. Ethylcellulose...160
  • Gonioscopic fluid substitutes...162
  • Making gonioscopic fluid...162
  • Diluting methylcellulose...163
  • Air bubbles in the gonioscopic fluid...163
Pages: 159-163

Chapter 25: Other Equipment

  • Cameras and photographing floaters...164
  • Elbow support...166
  • Room light...167
  • Foot rest...167
Pages: 164-167

Chapter 26: Patient Satisfaction And 15 Memorable Cases

Pages: 168-171

Chapter 27: Future Use Of The YAG Laser In The Vitreous

  • Treatment of persistent vitreous hemorrhage...172
  • Treating macular holes and membranes...172
  • Treating subhyloid hemorrhage...172
Pages: 172-173

Appendix

  1. Office work up form...174
  2. Operative permit...175
  3. Pre-operative instructions...176
  4. Post-operative instructions...177
  5. Explanation of multiple floaters...178
  6. Summary of the world literature...179
  7. Insurance codes...183
  8. Karickhoff Floater Finder...184
  9. One year follow up form...186
  10. Karickhoff Mosaic Matcher ©, (Corneal Endothelial Cell Estimates at the Slit Lamp in 15 Seconds)...188
  11. Karickhoff Flying Corpuscle Viewer TM (Macular function test when the macula can not be seen)...190
  12. Karickhoff Simplified Outflow Facility Testing...194
  13. Karickhoff Vitreous Treatment Lenses... 200
  14. Designing the ideal laser for floater treatment...201
  15. Dr. Karickhoff's contributions to laser treatment of floaters...205
  16. Dr. Karickhoff's contributions to ophthalmology...207
  17. Curriculum Vitae...210-226
  18. About the Author...227
Pages: 174-227

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