Normally the vitreous is clear. This is formed in 99% water, but it contains a light mesh of collagen fibers that can degenerate causing the “floaters”. The other main constituents of the vitreous are soluble proteins (mainly acidic lipoproteins and serum proteins) and hyaluronic acid.
The hyaluronic acid molecules retaining water, damage to the vitreous its gelatinous consistency. In the outer part of the vitreous, the collagen fibrils condense and produce the “hyaloid membrane”.
In a normal eye this structure lies against the inner limiting membrane of the retina, but due to aging, disease or previous ocular trauma is often separated and moves centrally.
When the vitreous decreases in the eye due to an injury or a surgical procedure, the body does not reform and the space is naturally filled with aqueous fluid or, by the surgeon, with fluid, gas or silicone oil.
THE FORMATION OF MOVING BODIES
The most common degeneration of the vitreous are: liquefaction (syneresis), the opacification and coarctation (narrowing).
The degeneration is the most common Liquefaction, this occurs with aging, myopia, trauma, accidental contact with iron or copper, an inflammatory process and other rarer causes.
In the aging process the molecules of hyaluronic acid release their water molecules and form pockets of liquefied vitreous. When this happens, the collagen structure collapses and merges into fibrils. The process is irreversible.
The liquefaction produces usually opacity reading, but in some people, these opacities are more severe and interfere with driving, reading, computer user and on employment.
Patients report seeing small particles moving in their visual field. It is more noticeable when the background is bright and homogeneous (eg, looking out the window of an airplane sky completely clear or cloudy). The vision of the floater has a component speed of 1 second and a slow component of about 5 seconds when this returns to its previous position.
The opacity of the colloid gel may present as extremely small, wispy, with filaments or membranes. Those that disturb broad and most are the ones closest to the retina causing a real shadow on the same. This shadow can disturb your field of vision, work and quality of life. Opacity sudden, never seen before, and especially if the device, however, may indicate a hemorrhage due to a retinal tear.
The Floaters caused by blood usually resorb spontaneously, but those formed by collagen or fibrin are absorbed very little. When the movable body is formed for Coarctation of the vitreous and condensation glial separating from the optic nerve head, leaving the so-called “ring Weiss” in the vitreous mean central, the possibility of resorption is very limited, but this kind of Floater is what has most likely to be fully vaporized with the YAG laser, both for its consistency to that the fact of being equidistant from the retina and the lens.
TECHNICAL YAG LASER
There are mainly three basic techniques for the treatment of floaters with the Yag Laser: the vaporization, the Relocation and thinning.
The floaters that come from the inner limiting membrane after a posterior vitreous detachment (Weiss rings and other moving bodies in nature hyaline) are hit directly with the laser light. These soft floaters are attached to the rear face of the vitreous and are those that are more easily vaporized completely.
The floaters shaped clouds that are suspended in the axis of vision are treated in an indirect way by cutting the top of the thin filaments that hold them in place. Frequently these fall down, and relocate it no longer interfere in the vision. It is processed directly if you do not fall.
The floaters that are developed for a primary degeneration of the vitreous (syneresis) are usually multiple, fibrosis and more difficult to vaporize. You can also highlight a hundred floaters. Not being able to perform such a large number of spot, to avoid overheating the vitreous,trying to diradarli and assottigliarli.
In conclusion, my basic principle is to get the best results with the least possible involvement of the laser, so if I can relocate the few spots and floaters using little power.
When the cabinet is too close to these structures ,we had to protect the lens or the retina with specific techniques and treatment to move them.
Tagged with: cure eye floaters • eye floaters treatment • laser treatment of eye floaters
Filed under: Laser treatment of eye floaters • What are eye floaters
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