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Doctors debate using lasers for eye floaters

In this ophthalmic photograph released by Dr. John Karickhoff, a patient's eye is seen after its ring shaped eye floater was removed.
Innovation or waste of time?

FALLS CHURCH, Va. — Some people call them floaters. Eye doctors call them "vitreous opacities."

Emily Flynn called hers "a little fuzzball," and she flew halfway around the world to have it removed.

After more than 100 pinpoint zaps from a laser beam during a half-hour visit to a northern Virginia office park, the fuzzball was gone, obliterated within the clear, gelatinous goo that fills the eyeball.

The surgeon, John Karickhoff, has done the same procedure more than 1,400 times over the past 15 years and claims a success rate of better than 90 percent, with minimal risk of complications. Still, many ophthalmologists have never heard of the procedure — and most would recommend against it. The procedure has drawn regulatory scrutiny in Florida.

Nearly everybody has floaters or will develop them at some point in life, especially older and nearsighted people. Sometimes shaped like specks or snakes, they float through a person's field of vision, and are most easily seen when you look against a light background like a blue sky or a white wall.

They are harmless, usually just bits of membrane that have become dislodged from other parts of the eye. Karickhoff estimated that 95 percent of people who have floaters ought to leave them alone. But for that 5 percent, they can be a legitimate problem.

"I've had musicians who couldn't read the sheet music quickly enough because the floater would get in the way," said Karickhoff, who has tried for years to get the procedure accepted into the medical mainstream. "It can ruin a patient's quality of life."

Only a handful of doctors in the United States — perhaps as few as two — regularly treat floaters with laser surgery.

Richard Bensinger, a spokesman for the American Academy of Ophthalmology, said most ophthalmologists believe the procedure is unnecessary. He acknowledged the laser treatment is often successful and carries little risk, but most doctors believe any risk is unacceptable for treating a benign condition like floaters.

If patients insist on treatment, Bensinger said the laser treatment can be a better choice than the more common alternative, a vitrectomy, which involves removing most or all of the eyeball's internal fluid.

Oliver Hill, 60, of Waynesburg, Pa., said many eye doctors are too dismissive of how irritating a floater can be. He compared it to trying to read a book while holding a pencil directly in front of one of your eyes.

"It just drove me right up the wall," said Hill, who had his left eye treated in June 2005 and returned to Karickhoff in November to treat a floater in his right eye.

In Flynn's case, her optometrist in New Zealand told her that floaters were common and not harmful, and that she should learn to live with it. She learned about Karickhoff from his Web site.

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