1. Floaters result from structural abnormalities in vitreous. They are a more common complaint th... more 1. Floaters result from structural abnormalities in vitreous. They are a more common complaint than previously known and have a more negative impact on the quality of life than previously appreciated. 2. Vision is adversely affected by vitreous light scattering causing straylight glare and degradation of contrast sensitivity. This explains the considerable degree of unhappiness experienced by patients suffering from floaters. 3. The only proven and safe treatment that effectively cures floaters and improves vision as well as patient well-being is limited vitrectomy.
Aims The long-term results of office-based pneumatic retinopexy (PR) using only filtered air were... more Aims The long-term results of office-based pneumatic retinopexy (PR) using only filtered air were evaluated in a case series of rhegmatogenous retinal detachments with more than 3 years of follow-up, on average. Methods 77 cases of primary rhegmatogenous retinal detachments arising from superior tears (mean¼1.6 tears) were treated with cryopexy (n¼61) or laser (next day, n¼16) and intravitreal injection of pure air in an office setting. The macula was detached preoperatively in 37 eyes (48.1%). Outcome measures were singleoperation success, final reattachment rates and visual acuity (VA). Results Subjects were followed for 6e186 months (mean follow-up ¼ 40.7 months, 46.8% $2 years, 25% $5 years). In all cases, the air bubble was gone within 5 days. Single-operation success was achieved in 62/77 (80.5%) eyes. Repeat PR was successful in four cases, increasing the PR reattachment rate to 85.7%. Scleral buckle was performed on the remaining 11 eyes (14.3%), 1 with vitrectomy. The final reattachment rate was 100%. VA improved $2 Snellen lines in 53.2% of patients, with 50/77 (64.9%) attaining VA $20/40. Following PR, 87% of subjects had the same or better VA. Conclusions Office-based pure-air PR achieves acceptable reattachment rates with good visual outcomes and long-term efficacy. Eliminating the need for expansile gases makes this approach more widely available, decreases recovery time and lowers healthcare costs.
Floaters impact vision but the mechanism is unknown. We hypothesize that floaters reduce contrast... more Floaters impact vision but the mechanism is unknown. We hypothesize that floaters reduce contrast sensitivity function, which can be normalized by vitrectomy, and that minimally invasive vitrectomy will have lower incidences of retinal tears (reported at 30%) and cataracts (50-76%). Seventy-six eyes (34 phakic) with floaters were evaluated in 2 separate studies. Floater etiologies were primarily posterior vitreous detachment in 61 of 76 eyes (80%) and myopic vitreopathy in 24 of 76 eyes (32%). Minimally invasive 25G vitrectomy was performed without posterior vitreous detachment induction, leaving anterior vitreous, and using nonhollow probes for cannula extraction. Efficacy was studied prospectively (up to 9 months) in 16 floater cases with Freiburg Acuity Contrast Testing (Weber index [%W] reproducibility = 92.1%) and the National Eye Institute Visual Function Questionnaire. Safety was separately evaluated in 60 other cases followed up on an average of 17.5 months (range, 3-51 mont...
Objectives Vitreoschisis is a possible pathogenic mechanism in macular diseases. Thus, the vitreo... more Objectives Vitreoschisis is a possible pathogenic mechanism in macular diseases. Thus, the vitreoretinal interface was evaluated in monkey eyes and patients with various macular diseases in search of vitreoschisis. It is hypothesised that vitreoschisis is present in macular holes (MH) and macular pucker (MP), but not in other maculopathies.
1. Floaters result from structural abnormalities in vitreous. They are a more common complaint th... more 1. Floaters result from structural abnormalities in vitreous. They are a more common complaint than previously known and have a more negative impact on the quality of life than previously appreciated. 2. Vision is adversely affected by vitreous light scattering causing straylight glare and degradation of contrast sensitivity. This explains the considerable degree of unhappiness experienced by patients suffering from floaters. 3. The only proven and safe treatment that effectively cures floaters and improves vision as well as patient well-being is limited vitrectomy.
Aims The long-term results of office-based pneumatic retinopexy (PR) using only filtered air were... more Aims The long-term results of office-based pneumatic retinopexy (PR) using only filtered air were evaluated in a case series of rhegmatogenous retinal detachments with more than 3 years of follow-up, on average. Methods 77 cases of primary rhegmatogenous retinal detachments arising from superior tears (mean¼1.6 tears) were treated with cryopexy (n¼61) or laser (next day, n¼16) and intravitreal injection of pure air in an office setting. The macula was detached preoperatively in 37 eyes (48.1%). Outcome measures were singleoperation success, final reattachment rates and visual acuity (VA). Results Subjects were followed for 6e186 months (mean follow-up ¼ 40.7 months, 46.8% $2 years, 25% $5 years). In all cases, the air bubble was gone within 5 days. Single-operation success was achieved in 62/77 (80.5%) eyes. Repeat PR was successful in four cases, increasing the PR reattachment rate to 85.7%. Scleral buckle was performed on the remaining 11 eyes (14.3%), 1 with vitrectomy. The final reattachment rate was 100%. VA improved $2 Snellen lines in 53.2% of patients, with 50/77 (64.9%) attaining VA $20/40. Following PR, 87% of subjects had the same or better VA. Conclusions Office-based pure-air PR achieves acceptable reattachment rates with good visual outcomes and long-term efficacy. Eliminating the need for expansile gases makes this approach more widely available, decreases recovery time and lowers healthcare costs.
Floaters impact vision but the mechanism is unknown. We hypothesize that floaters reduce contrast... more Floaters impact vision but the mechanism is unknown. We hypothesize that floaters reduce contrast sensitivity function, which can be normalized by vitrectomy, and that minimally invasive vitrectomy will have lower incidences of retinal tears (reported at 30%) and cataracts (50-76%). Seventy-six eyes (34 phakic) with floaters were evaluated in 2 separate studies. Floater etiologies were primarily posterior vitreous detachment in 61 of 76 eyes (80%) and myopic vitreopathy in 24 of 76 eyes (32%). Minimally invasive 25G vitrectomy was performed without posterior vitreous detachment induction, leaving anterior vitreous, and using nonhollow probes for cannula extraction. Efficacy was studied prospectively (up to 9 months) in 16 floater cases with Freiburg Acuity Contrast Testing (Weber index [%W] reproducibility = 92.1%) and the National Eye Institute Visual Function Questionnaire. Safety was separately evaluated in 60 other cases followed up on an average of 17.5 months (range, 3-51 mont...
Objectives Vitreoschisis is a possible pathogenic mechanism in macular diseases. Thus, the vitreo... more Objectives Vitreoschisis is a possible pathogenic mechanism in macular diseases. Thus, the vitreoretinal interface was evaluated in monkey eyes and patients with various macular diseases in search of vitreoschisis. It is hypothesised that vitreoschisis is present in macular holes (MH) and macular pucker (MP), but not in other maculopathies.
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