EyeWorld Asia-Pacific December 2015 Issue

Retina: A cataract surgeon’s guide to anti-VEGFs December 2015 33 EWAP SECONDARY FEATURE Avoid treating in the direction of the macula, optic nerve or blood vessels, and stop treatment if you see corneal edema. Dr. Brasse recommends treating floater strands in the anterior vitreous first and working posteriorly. In this manner, you can vaporize floaters that may block your view of the posterior structures. Dr. Brasse warns, however, to avoid combining YAG capsulotomy and floater vitreolysis in the same session. Because the cavitation gas bubbles travel upward, they can block the field of view, so Dr. Brasse recommends starting from the top of the floater and working downward. He also recommends treating floaters from the periphery to the center, so that no particles float away and get lost in the vitreous. A small percentage of patients do experience pressure spikes after treatment, so Dr. Brasse applies dorzolamide/timolol twice immediately after laser treatment to keep the IOP low. He also prescribes prednisolone 1% eye drops every 30 minutes for the rest of the day, followed by 6 times daily for 1 week. Be sure to examine patients the next day to check visual acuity and IOP. Dr. Singh does not routinely give anti-hypertensive or anti- inflammatory drops postoperatively, but does stress the importance of checking pressures within a couple IMAGING SOLUTIONS From the leader in slit lamp imaging Outstanding image quality Equipped with an ultra-sensitive camera the new IM 900 produces images of exceptional quality even under difficult light conditions. Simple image capturing Fast and accurate automatic exposure control allows sim- ple image capturing while you are concentrating on the patient. Perfect network integration EyeSuite makes your slit lamp networkable both with other Haag-Streit devices and your practice network. www.haag-streit.com ADV_Imaging_EyeWorld_ Asia_Pacific_21082015.indd 1 24.08.2015 14:30:19 of weeks. Patients at higher risk for an IOP spike are those patients who are pseudophakic/post-YAG capsulotomy and who have anterior floaters. He thinks the gas bubbles may travel into the anterior chamber and can potentially disrupt the outflow system. Finding the right patients Dr. Singh routinely asks patients during the eye exam if they have any issues with floaters. “I don’t go out looking for patients,” Dr. Singh said. “These patients are in your office already. We’ve conditioned our patients to realize that nothing can be done, so patients stop complaining about them. So when you start asking patients, you’ll find them.” Remember that you don’t have to get rid of every floater for the patient to be visually satisfied, he added. The goal is to achieve a functional improvement in vision so that patients can easily perform their routine day-to-day activities. For more information, visit Dr. Karickhoff’s website at www. eyefloaters.com or Dr. Brasse’s website at www.floater-vitreolysis. net for presentations he has given on the topic. Visit the Ellex website at www.ellex.com for videos from Dr. Singh and information about the laser and further treatment guidelines. EWAP Editors’ note: Drs. Singh and Brasse have financial interests with Ellex. Contact information Brasse: brasse@augenarzt-vreden.de Singh: ipsingh@amazingeye.com