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Glaucoma Awareness Month

March is Glaucoma Awareness month in New Zealand. Watch Dr Perumal explain key concepts in glaucoma here:

Learn more about glaucoma awareness month

What is an ICL?

  • Implantable Contact Lenses(ICLs) could be a perfect option for individuals with a high prescription, a thin or weak cornea or persistently dry eyes.
  • ICLs are flexible plastic lenses that augment your natural lens and correct the eye’s refractive – or focusing - issues. They are practically invisible and, once implanted, they continue to do their job for decades. Even better, many patients like the idea that ICLs are reversible/removable if desired.
  • The lens design has been optimised since first introduced in the 1990s making the surgery even safer. To date, there have been over 1,000,000 ICLs successfully implanted worldwide.
  • Our Re:Vision surgeons have done more ICL surgeries than any other clinic in NZ.

What is Glaucoma?

Glaucoma is a disease that damages the nerve at the back of your eye, called the optic nerve. The optic nerve sends the signals to the brain that enables you to see. Glaucoma is associated with increased sensitivity to pressure within the eye. The eye’s aqueous fluid is constantly produced and drained at a balanced rate and forms the intraocular pressure within the eye (IOP). When this drainage is reduced, or if there is too much fluid production, IOP increases and leads to damage of the optic nerve.

Image of the optic nerve showing loss of nerve cells in patients with glaucoma.

Glaucoma typically has no symptoms. Most patients do not experience any issues until they visit their eyecare provider. Untreated glaucoma can cause a gradual loss of vision, usually starting in the periphery which may go unnoticed for long periods of time.

Image showing the effect of loss of sight in patients with glaucoma.

Our Process :

Complete a complementary LASIK/ICL suitability test


Detailed measurements of the eyes are taken for safety and accuracy, and the team will discuss your options. If you wear contact lenses, please leave them out and wear glasses for two full days prior to the day of your assessment.

Patient meeting their Surgeon.

Meet your surgeon

Usually, at the same visit, you will meet your surgeon who will thoroughly examine your eye and discuss your eyesight problems and treatment options. Approximately 2-3 weeks are requiredfor delivery of non customised lenses and 4-6 weeks for custom made lenses. Uponthe arrival of your ICL, our team will contact you to finalise and confirm thedate of your procedure.

Treatment day

On the day

You will be at Re:Vision for around two hours. After your painless procedure which typically takes less than 10-15 minutes you will be kept comfortable and can choose from a series of snacks. Both eyes are typically done on the same day. You will need someone to drive you home.



The recovery following ICL surgery is remarkably quick with most individuals having minor irritation for the first few hours after the procedure. Most of our patients enjoy better than driving standard vision the next day and can go back to normal activities. Vision will continue to improve as the ICL settles and the pupil becomes smaller over a period of 1-2 days. You will not be able to feel the artificial lens in your eye.

check up

Check up

Your first check will be the day after surgery. Almost all patients have better than driving standard vision and are back to work after one quiet day.


Saving money

The hidden costs: what could you save?

What could that money have done?

The $40,000 you'd potentially spend on glasses and contact lenses over the next 30 years could have given you 15 luxurious holidays.

Est- 15 Holidays

Est - 15 Holidays

Average holiday cost: $2600
Calculation: 40,000 / $2600 = 15

Saving time

The hidden cost of wearing glasses or contact lenses.

Did you know?

The time you'd spend handling glasses and contact lenses over the next 30 years is enough to have could have taken you around our planet over 30 times!

Est - 526 hours

Est- 526 hours

Cleaning: 3 minutes/day
Finding misplaced glasses: 2 minutes/day
Repair, shopping: 2 hours/year
Total: 526 hours (over 30 years)

Est- 526 hours

Inserting and Removing: 3 minutes/day
Cleaning: 2 minutes/day
Renewing & Check-ups: 2 hours/year
Total: 1,012 hours (over 30 years)

Saving planet

Reducing our carbon footprint

The environmental perspective

Over 30 years, using glasses and contact lenses contributes to 876lb of CO2 emissions. Opt for vision correction and take a stand for our planet!

Est - 876.6lb C02 emissions

Est- 876.6 CO2 emissions

Combined plastic waste:

0.525 kg (glasses)+65.7 kg (contact lenses)=66.225 kilograms over three decades.

Total: 66.225 kilograms of plastic×6=397.35 kilograms = 876Lb of CO2 emissions(over 30 years)

Benefits of ICL Surgery :

Incredible vision, fast

Today, more than 1,000,000 people worldwide are enjoying the benefits of the ICL. In one study more than 98% of US Military patients were seeing 20/20 or better, and 99.4% of patients with ICLs would have ICL procedure again.

Huge range of correction

Suitable candidates for ICLs include: • Myopia (short-sightedness) up to -20 dioptres • Hyperopia (long-sightedness) up to +10.00 dioptres • Astigmatism up to 6.00 dioptres

Nothing is removed

ICL surgery is suitable for patients with thin or weak corneas as no corneal tissue is removed to achieve vision correction.

No more dry eyes

ICL surgery does not lead to changes in the tear film and is therefore suitable for patients who have pre-existing dry eye problems.


Unlike LASIK, the ICL is a reversible procedure and can be removed in the future if necessary. ICLs are not sewn or glued into the eye, they simply rest in the natural space between the lens and the iris.

Personalised Surgical Care

Some patients are not suitable for drops or laser therapy and require either cataract surgery, minimally invasive glaucoma surgery or complex glaucoma surgery.

Minimally invasive Glaucoma surgery (MIGS) marks a milestone in the advancement of glaucoma patient care. MIGS are a form of glaucoma surgery which is associated with minimal incisions, and are generally associated with lower risks in restoring normal eye pressure.

Prior to MIGS, treatment options were limited to medications, laser and major glaucoma tube and filtration surgery. Now, with MIGS, our team at Re:Vision have more treatment options which benefits a patient with faster recovery , less surgical risks and less dependence on medications following surgery.

Our surgeon is a leader in MIGS surgery in NZ, with a wealth of experience with iStent -W, Kahook Dual Blade, Hydrus, XEN, Preserflo, micropulse and cyclodiode laser.

MIGS management include:
1) Various treatment options and benefits which are patient centric and individualised
2) Evidence based therapy and
3) Promising outcomes for glaucoma patients.

MIGS can be performed as a standalone procedure or in conjunction with cataract surgery. There are different surgical approaches under the MIGS umbrella, but they generally are designed to allow more fluid to drain out of the eye and hence, reduce intraocular pressure.

a) iStent

The iStent is the smallest medical device ever implanted into humans. The iStent decreases eye pressure by creating a pathway into the eye’s drainage system. The iStent was the first trabecular micro-bypass device approved by the FDA and is the most thoroughly-studied glaucoma device on the market.

Click here to watch video on iStent

b) Kahook Dual Blade

The Kahook Dual Blade goniotomy procedure involves removing a section of the trabecular meshwork (the part which is associated with the greatest resistance in fluid outlflow) and hence increasing drainage out of the eye.

Click here for information on KDB

c) Micropulse Laser Treatment

This procedure decreases the amount of fluid produced by the eye and increases fluid outflow. A probe is placed on the surface of the eye and the surgeon applies laser energy to part of the eye which controls the production of fluid in the eye.

d) Preserflo Stent
The Preserflo drainage shunt is type of microshunt implant used to reduced intraocular pressure by creating a controlled pathway for the drainage of fluid out of the eye. It is made from a specialised biocompatible material called SIBS, which is known for its stability, flexibility and compatibility with the human body, hence minimising tissue inflammation.

Click here for information on Preserflo

Trabeculectomy surgery has been done for more than 50 years, and involves making a separate channel for fluid to filter out of the eye.

A drainage tube is a device inserted into the eye, which acts as straw where fluid can access to drain out of the eye onto the outer coat of the eye. There are several drainage tubes available in NZ which include Molteno drainage tube, Paul drainage tube and Baerveldt drainage tube.

Generally, these surgeries are done once all others have been exhausted and have failed to stop the progression of glaucoma.

Glaucoma is optic nerve damage due to increased pressure sensitivity within the eye while a cataract is a clouding of your natural lens within your eye.

In some patients, the hardening and change in the shape of the lens with the development of cataract, can potentiate the effects of glaucoma, such as angle closure glaucoma. In this situation, we may suggest having cataract surgery as a way to treat your glaucoma.

Some patients can combine glaucoma and cataract surgery (includes patients with open angle glaucoma). MIGS procedures in particular can be performed through the same incision as cataract surgery, providing an efficient way to address two problems at once.

Our Technology:

Peramis Wavefront Aberrometer

There are 25 measurable causes of defocus in our eyes. These defocus errors are called aberrations and are precisely measured by an aberrometer. With accurate measuring and laser treatment of these aberrations, we can achieve high-definition vision even clearer than glasses can provide. Older laser technologies, and SMILE, only measure and treat 2 defocus errors, compared to 25. Wavefront aberrometers allow laser surgeons to precisely analyse the optics of the eye. The Peramis aberrometer has six times higher resolution than other systems. This exceptional performance is based on a high-resolution pyramidal wavefront sensor that measures ocular wavefront aberrations with an unequaled 45,000 measuring points. Together with the integrated high-resolution topography with Placido technology, this allows for an extremely accurate assessment of corneal and ocular aberrations. This data allows your surgeon to individually customise the wavefront-based correction of your vision.

Ultra Precise Eye Measurements

Sirius Tomographer

Combines Placido disk topography with Scheimpflug tomography of the front of the eye to allow the surgeon to perform the safest version of laser vision correction customised to your eyes. The device provides highly accurate measurements of corneal thickness, curvature, power as well as pupil size measurements and is commonly used for refractive surgery planning and follow-up.

Detailed Corneal Analysis

Staar Visian ICL

The Staar Visian ICL lenses are custom made in Switzerland to match your eye’s unique measurements. ICLs can correct up to 20 Dioptres of short-sightedness, 10 Dioptres of long-sightedness) and up to 6.0 Dioptres of astigmatism. Today, more than 1,000,000 people worldwide are enjoying the benefits of ICL surgery.

Biocompatible Contact Lens

Custom Built Surgical Facility

Re:Vision Laser & Cataract was specifically designed and created by our surgeons to provide maximum safety for patients in need of eye surgery. We are fully accredited by the Designated Auditing Agency (DAA) with an excellent scoring.

Custom Built Facility

How the ICL Procedure Works:

woman and man having a glass of wine over a cheese board
  • Unlike your traditional contact lenses you cannot feel phakic intraocular lenses in your eyes.
  • The ICL is made of collamer, a highly biocompatible advanced lens material which contains a small amount of purified collagen. Collamer does not cause a reaction inside the eye and contains an ultraviolet blocker that protects the eye.
  • A big advantage of ICL is that it can permanently correct your vision; yet no natural tissue is removed in any way during the procedure. If for the unlikely reason you need or wish to remove your ICLs in the future, it can be done.
  • Glaucoma Research at Re:Vision

    Dr Perumal values the importance of research initiatives and technology in glaucoma. We may invite you to participate in the Save Sight Registry run by the Save Sight Institute, in collaboration with the University of Sydney and Sydney Eye Hospital to fight glaucoma blindness.

    The Save Sight Registries is one of the most advanced ophthalmic registries in the world, and is a unique platform for tracking eye disease, interventions and patient outcomes. Its sophisticated design delivers real-world evidence on the risks and benefits of current and new treatments for ocular conditions. This information helps clinicians provide safe, cost-effective and evidence-based solutions for vision impairment and avoidable blindness.

    The Save Sight Registries also promotes international scientific research aimed at developing strategies for reducing the incidence of blindness throughout the world.

    How much do Implantable Contact Lenses cost?

    ICL surgery is more expensive than laser eye surgery but exact costs depend on your prescription and whether you have astigmatism.

    By the time I turn 45, I will have spent on contact lenses/glasses :

    At Re:Vision, all types of laser vision correction
    (LASIK or PRK) cost : $3,494/eye

    References :

    • Tavasoli S, Ziaei M. Current Advances in Ocular Surgery, Implantable Collamer lens (ICL), Springer, 2021
    • Bhikoo R, Rayner S, Gray T. Toric implantable collamer lens for patients with moderate to severe myopic astigmatism: 12-month follow-up. Clin Exp Ophthalmol. 2010 Jul;38(5):467-74.
    • Rayner SA, Bhikoo R, Gray T. Spherical implantable collamer lenses for myopia and hyperopia: 126 eyes with 1-year follow up. Clin Exp Ophthalmol. 2010 Jan;38(1):21-6.