I got a question about which I laser I use

"Could you tell me the specific make and model of the YAG laser system your clinic uses for vitreolysis?

Specifically, does the system feature True Coaxial Illumination (such as an Ellex Reflex platform)?"

I think this is a really interesting question to ask me. It 'suggests' that you have been doing your internet research, perhaps finding some marketing material from Ellex (now, Lumibird). About 10+ years ago Ellex introduced their newer model of the Ultra-Q called the Ultra-Q reflex. The main modification was not to the laser itself, but the illumination tower, that is, the light source where we can see into the vitreous space. The advantage of coaxial lighting while treating is theoretical and probably makes sense to the optical and product engineers. It makes for good marketing material and in the several page .pdf handout that Ellex produced as their 'commitment' to training they claim that it is almost necessary to have coaxial lighting to be able to treat eye floaters.

Would it change your opinion if I told you I treated for 15 years without coaxial illumination, that I have an argument that in less experienced hands, using coaxial illumination will increase the risk of retina or lens injury because there is an inherent loss of visual confidence as to where the laser is focused.

That said, I have both lasers and use them both. With the Ultra-Q Reflex I RARELY ever use coaxial illumination, but will often use that laser because it has a fan to cool the laser source and I can use it without overheating.

But, with more difficult floaters (peripheral, posterior, low contrast), or through difficult optics (multifocal lenses, small pupils, cataract, etc) I will usually use the older laser as the optics are simply better.

I gotta say, it is a distinct advantage to have both laser and to know the advantages and disadvantages of both.