Video

Clinical Videos

Laser Floater Removal:
On-Axis and Off-Axis

The Ultra Q Reflex incorporates a proprietary slit lamp illumination tower design, which converges the operator’s vision, the target illumination, and the treatment beam along the same optical path and onto the same optical plane. The illumination tower can be used coaxially to enhance the view of the target opacity and more effectively vaporize it.

“I think it is vitally important for the surgeon to appreciate spatial context. It is crucial to understand how far behind the lens you can treat. I utilize the on-axis feature first to visualize a floater against the red-glow background (to help visualize floaters in the middle and posterior vitreous), and then I go off-axis to determine how far behind the lens it is. If the floater is hard to see in off-axis mode then I know that it is safe to treat since off-axis setting only allows for visualization 1-2 mm behind the lens.”

Source: Video courtesy of Paul Singh, MD (USA).

Laser Floater Removal Through a Multi-Focal Lens

In this video, US physician Paul Singh uses the Ultra Q Reflex laser to perform laser floater removal through a multi-focal lens. The videos shows how coaxial illumination provides more spacial context i.e. lens to the retina; when the retina is not in focus he knows that he is in the middle of the vitreous and treatment can proceed accordingly. Average power setting was 6.0 mJ.

Source: Video courtesy of Paul Singh, MD (USA).

Laser Floater Removal:
Clinical Footage

Because the YAG laser energy has to pass through more optical media than during capsulotomy treatment, more energy will typically be required to perform laser floater removal. Regardless, always start with a low level of energy and titrate up until there is adequate vaporization and optical breakdown of the vitreous collagen.

Source: Video courtesy of Paul Singh, MD (USA).

Laser Floater Removal:
Clinical Footage

Commence treatment with a single pulse per shot. Set energy at the minimum level required to create the optical breakdown in the vitreous cavity (typically 2-2.5 mJ).

Source: Video courtesy of Paul Singh, MD (USA).

Laser Floater Removal:
Clinical Footage

More energy will be required if the floater is located deep in the posterior vitreous. For example, the same floater may be vaporized at 3 mJ in the anterior vitreous, at 4 mJ in the mid-vitreous and 5 mJ in the posterior vitreous.

Source: Video courtesy of Paul Singh, MD (USA).

YAG Laser Floater Removal:
Clinical Footage (Video 1 of 2)

For Nd:YAG laser-based floater treatment, the Ultra Q™ with Reflex Technology™ (Ellex) provides optimal illumination of the vitreous. A proprietary slit lamp illumination tower design converges the operator’s vision, the target illumination and the treatment beam onto the same optical path, and focuses them onto the same optical plane. This is of particular importance when aiming at vitreous strands or floaters, as it greatly minimizes the potential for focusing errors, and the risk of damage to the natural lens or the retina. The Reflex illumination mirror, which briefly moves out of the laser pathway during firing, ensures that the laser beam is never obstructed. The illumination tower can thus be used coaxially, in addition to the typical off-axis position.

Source: Video courtesy of Feike Gerbrandy, MD. Opsis. Amstelveen, Netherlands.

YAG Laser Floater Removal:
Clinical Footage (Video 2 of 2)

For Nd:YAG laser-based floater treatment, the Ultra Q™ with Reflex Technology™ (Ellex) provides optimal illumination of the vitreous. A proprietary slit lamp illumination tower design converges the operator’s vision, the target illumination and the treatment beam onto the same optical path, and focuses them onto the same optical plane. This is of particular importance when aiming at vitreous strands or floaters, as it greatly minimizes the potential for focusing errors, and the risk of damage to the natural lens or the retina. The Reflex illumination mirror, which briefly moves out of the laser pathway during firing, ensures that the laser beam is never obstructed. The illumination tower can thus be used coaxially, in addition to the typical off-axis position.

Source: Video courtesy of Feike Gerbrandy, MD. Opsis. Amstelveen, Netherlands.

YAG Laser Floater Removal:
Weiss Ring Floater

A Weiss Ring Floater is larger in size in comparison to other floaters and occurs when the vitreous tissue surrounding the optic nerve becomes separated from the back of the eye. Typically, a Weiss Ring Floater appears like a big ring-shaped floater which is seen clearly against a light background. Whilst floaters are often considered benign — a minor and short-lived inconvenience — for some patients, including those with low tolerance of visual obscurations, the presence of floaters can become a disabling condition. In these cases, Nd:YAG laser-based floater treatment offers a viable treatment solution.

Source: Video courtesy of Feike Gerbrandy, MD. Opsis. Amstelveen, Netherlands.

Physician Interviews

Laser Vitreolysis for the Refractive Surgeon

In this video interview, refractive specialist Karl G. Stonecipher, MD (Clinical Associate Professor of Ophthalmology at the University of North Carolina, and Medical Director of TLC Laser Eye Centers in Greensboro, North Carolina) addresses his decision to incorporate laser floater removal into clinical practice.

“For many if not most of my refractive surgery colleagues, the idea of treating floaters with a YAG laser was taboo. They felt it was crossing a line, that these were healthy eyes that did not require surgical intervention, and that the risks outweighed any potential benefits. I understood and even shared some of their skepticism, but I really felt that we owed it to our patients to offer them something more than just a sympathetic ear when they explained the negative impact of floaters on their quality of life.”

Video Interview with Karl G. Stonecipher, MD (Clinical Associate Professor of Ophthalmology,University of North Carolina, and Medical Director of TLC Laser Eye Centers, Greensboro, North Carolina, USA)

Modern Laser Vitreolysis

Compared with its early clinical use in the 1980s, modern laser vitreolysis provides more efficient and safer energy profiles, offering reliable and repeatable outcomes that provide a low rate of complications combined with a high degree of patient satisfaction. In this interview, Dr. Karl Brasse addresses his experience to date using the Ultra Q Reflex laser in the treatment of symptomatic floater patients.

“Karickhoff, one of the original pioneers of laser vitreolysis, in my opinion, may have advocated the procedure before its time; the technological capabilities were not as superior as they are today. I strongly believe that the success I have encountered with laser vitreolysis is due to the system that I use.”

Video Interview with Karl Brasse, MD MRCOphth (Germany)

Vitreolysis. Redefining Convention

Clinical studies have shown laser floater removal to be an effective treatment approach for vitreous strands and opacities. It also offers a high degree of patient satisfaction. In this video interview, Paul Singh, MD, of The Eye Centers of Racine and Kenosha, Wisconsin, discusses the fundamentals of laser floater removal in the management of floaters.

Video Interview with Paul Singh, MD, The Eye Centers of Racine and Kenosha, Wisconsin, USA

YAG Laser Floater Removal:
Floater Treatment

Having performed more than 2000 laser floater removal procedures over the past five years, Dr. James H. Johnson, Medical Director of Vitreous Floater Solutions, Irvine, is considered an expert in the treatment of floaters. In this interview, Dr. Johnson provides his tips on treatment protocol for floater treatment.

Video Interview with 
James H. Johnson, MD, Vitreous Floater Solutions, Irvine, California

YAG Laser Floater Removal:
Results of 500 Eyes

Effective in 70-95% of all cases – and with a low complication rate and high degree of patient satisfaction – Dr. Feike Gerbrandy, The Netherlands, shares his insight for successful treatment of floaters with YAG laser floater removal.

Video Interview with 
Feike Gerbrandy, MD, Opsis Eye Hospital, Amsterdam, The Netherlands

Vitreolysis in the Spotlight

In this video interview, Dr. Paul Singh of The Eye Centres of Racine and Kenosha, Wisconsin, shares his pearls for success with laser floater removal. Drawing on his experience with the Ultra Q Reflex™ multi-modality laser, he addresses a number of topics ranging from patient selection to treatment protocol, including recommended laser lenses and energy settings.

Video Interview with Paul Singh, MD, The Eye Centers of Racine and Kenosha, Wisconsin, USA

Vitreolysis. Redefining Convention

Prof. Marie-José Tassignon, MD, PhD, Antwerp University Hospital (Belgium), has been a pioneer in YAG laser floater removal. Prof. Tassignon explains how to test and classify floaters, and how to thereby determine which patients are eligible for treatment.

Video Interview with Prof. Marie-Jose Tassignon, MD, PhD, Antwerp University Hospital (Belgium)

Vitreolysis. Redefining Convention.

Video Interview with Dr. Carlo Orione

Miodesopsie: Vitreolisi con Laser Yag.

Dr. Carlo Orione

Video Interview with Dr. Carlo Orione

Webinars

A Paradigm Shift in the Management of Symptomatic Floaters

Having performed more than 250 YAG laser floater removal procedures, Dr. Paul Singh reports a success rate of more than 90%, combined with a high safety profile. Watch the webinar to learn more.

Webinar Recording with Paul Singh, MD (USA)

Vitreolysis: the Challenges and the Rewards

Laser floater removal is an outpatient-based procedure, which involves the use of a specially designed YAG laser to vaporize the vitreous strands and opacities. Highly effective, it has a low complication rate and offers a high degree of patient satisfaction. It can also delay or obviate the need for surgery.

Paul Singh, MD, Eye Centers of Racine and Kenosha, USA, 2013 annual meeting of the American Academy of Ophthalmology

Vitreolysis Vs. Vitrectomy

Vitrectomy is a highly effective treatment for the removal of vitreous strands and opactiies but also carries significant risks, including cataract. Laser floater removal is a simple, outpatient-based alternative, which vaporizes the vitreous strands and opacities and may delay or obviate the need for surgery.

Paul Singh, MD, Eye Centers of Racine and Kenosha, USA, 2013 annual meeting of the American Academy of Ophthalmology