Dr. Geller was invited to Italy to perform live floater laser surgery.
“I hear the same story all the time,” says ophthalmologist Scott Geller, MD. “It goes like this: a patient, usually in the forty to sixty-five age range, has the rapid onset of an eye floater [see special box, p.4]. The patient goes to an ophthalmologist who, as a matter of routine, takes his or her vision, which is typically normal for the patient, checks for a retinal tear or detachment, and, barring anything unusual, says to the patient, You’ll be okay. The retina looks fine and the floater will fade, or you’ll get used to it.
“The patient responds, But doctor, I can’t see.
“It is true that, for the majority of patients, floaters do seem to fade, or the patient does get used to it, but that’s not always the case.
“Here is the real issue,” he observes. “Ophthalmologists need to listen to the patient’s problem and thoroughly examine the vitreous gel, where eye floaters are formed. If they measure only the patient’s best vision on the eye chart, they may not correctly diagnose the problem, dismiss the patient out of hand, and tell him or her that nothing needs to be done. The patient is left bewildered and frustrated.
“This is one of the areas of ophthalmology that is routinely ignored by many ophthalmologists, and the reason for this is simple. They don’t take the patient’s visual acuity with the floater in the visual axis. The degree of lost vision can be significant, and this is especially critical in patients who have a lazy* opposite eye, or macular degeneration in the opposite eye.
“We do it differently,” assures the doctor. “We always try to measure the patient’s worst vision on the eye chart to see exactly how bad the vision gets with the floater obstructing it.”
Dr. Geller has performed thousands of floater laser procedures for over 20 years on patients from all over the world.
“We have a worldwide patient following and have helped people from Japan, the People’s Republic of China, Russia, and almost every European country,” notes the doctor. “In June of 2012, I saw patients in Italy at the office of Carlo Orione, MD, who visited us last year for training in the procedure. While in Italy, I gave a presentation to over two hundred Italian ophthalmologists at one of their major surgical conferences. I performed live surgery for glaucoma and demonstrated a new technique for them.”
Dr. Geller notes that this was not the first conference where he presented his technique and results to ophthalmologists: “The first was at the 1989 International Congress of Ophthalmology in Singapore. It was followed by lectures at several conferences in China, including the prestigious Shanghai Eye and Ear Institute. Other major meetings included the 1997 European Congress of Cataract and Refractive Surgery in Prague, the 1999 Florida Society of Ophthalmology, the 2001 European Congress of Ophthalmology in Istanbul, the 2010 World Congress of Ophthalmology in Berlin, and the 2010 American Society of Cataract and Refractive Surgery in Boston. There was also a peer-reviewed presentation at the American Academy of Ophthalmology in Chicago in 2012.”
The doctor says that he is surprised that all ophthalmologists don’t use the laser procedure for floaters. “Many doctors tell their patients, Live with it, Nothing can be done, or Get a vitrectomy surgery.
“The problem with vitrectomy surgery, which is the surgical removal of the entire vitreous gel [which is where floaters begin], is that it is not without its own problems. Most patients over the age of forty will develop an early cataract and will need another operation as early as six months to a year later. This is due to the physiology of the eye, not the skill of the surgeon.
“In my hands, with my years of experience, complications are rare.”
Dr. Geller confides that patients often find him in a roundabout way: “Recently, Mr. J.K. of West Palm Beach went to the satellite clinic of a world-famous Miami eye institute. They told him they couldn’t do anything for him except vitrectomy, but they did tell him, There’s an ophthalmologist on the West Coast of Florida who can treat your eye with laser.
“It wasn’t a direct referral, but the patient managed to find me and was ecstatic with his results. Subsequently, I uploaded a video of his procedure to YouTube.com and Vimeo.com, which can be found among dozens of videos I’ve posted.”
Dr. Geller cautions that not all patients can be helped with his laser procedure, but is pleased to report that, partially due to his meticulous patient selection process, his patient results are excellent.
According to Dr. Geller, he is one of the few surgeons in the country who have the Swiss-made LASAG Microruptor YAG laser: “This laser was specifically designed by renowned Professor Franz Fankhauser of the University Eye Clinic, Bern, Switzerland, to safely cut membranes deep in the eye’s interior.
“It is my experience that the YAG lasers used for glaucoma or cataract membranes will not work properly for surgery on floaters. In most cases, these other lasers are not optically made to work deep in the eye, nor are they as precise, which is the most important safety factor when working near the retina or crystalline lens.”
Dr. Geller says that, while his greatest satisfaction comes from helping patients who have been told by their own ophthalmologists that nothing can be done, he actually welcomes the opportunity to share his technique with others in his field: “Other ophthalmologists need only call me, or ask one of my patients about their results.
“I’m proud of our track record and of the patients we’ve helped.”
*Lazy eye occurs when the nerve pathway from one eye to the brain does not develop during childhood, and the brain learns to ignore the image from the weaker eye.