- Name:
- Laser Treatment of Eye Floaters
- Author:
- John R. Karickhoff, M.D.
- Book Size:
- 232 Pages
- Illustrations:
- 137
- Publisher:
- Washington Medical Publishing, LLC
- Copyright Date:
- 2005
- Language:
- English US
- ISBN-10:
- 0976897210
- ISBN-13:
- 978-0976897217
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
- Office work up form...174
- Operative permit...175
- Pre-operative instructions...176
- Post-operative instructions...177
- Explanation of multiple floaters...178
- Summary of the world literature...179
- Insurance codes...183
- Karickhoff Floater Finder...184
- One year follow up form...186
- Karickhoff Mosaic Matcher ©, (Corneal Endothelial Cell Estimates at the Slit Lamp in 15 Seconds)...188
- Karickhoff Flying Corpuscle Viewer TM (Macular function test when the macula can not be seen)...190
- Karickhoff Simplified Outflow Facility Testing...194
- Karickhoff Vitreous Treatment Lenses... 200
- Designing the ideal laser for floater treatment...201
- Dr. Karickhoff's contributions to laser treatment of floaters...205
- Dr. Karickhoff's contributions to ophthalmology...207
- Curriculum Vitae...210-226
- About the Author...227
Pages: 174-227