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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

These are wedge-shaped growths of thickened tissue that cross the junction of the white part and coloured part of the eye. Typically, a pterygium starts growing near the inside corner of the eye. It is not a cancer and will not develop into cancer. It does not usually require treatment unless it is interfering with vision, is noticeably growing or causes inflammation, or interferes with contact lens wear - in which case it should be removed.

Removal is simple, safe and quick, the healing is a little uncomfortable for a few days and red for a few weeks but this is a common procedure and we have fine-tuned the recovery to be minimally impactful however it is an operation which is expected to be sore for a few days afterwards.

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

Assessment

Detailed measurements of the eyes are taken for safety and accuracy, and the team will discuss your options.

1

Meet your surgeon

Usually, at the same visit, you will meet your surgeon who will thoroughly examine your eye and discuss your treatment options. Our surgeons are experienced with stitch-less modern surgical techniques and utilise tissue glue.

2

Procedure

You will be at Re:Vision for around 2 hours. The procedure is done with local anaesthesia with eyedrops and oral sedation if you want it. Either with or without some sedation you will need someone to drive you home. Your surgeon will use micro-instruments to peel away the pterygium and place an autograft (tissue from an area of normal conjunctiva) to fill the gap where the pterygium was as a barrier to try and reduce the chance of it growing back. The graft is secured with glue so no sutures are needed. This helps to minimise discomfort and improves healing and cosmetic outcomes. After your procedure which typically takes 20-30 minutes you will be kept comfortable and can choose from a series of snacks. Your eye will be numb for about 2-4 hours, and there will be an eye pad for 1-2 days. 

3

Rest

The recovery following pterygium surgery typically takes a few days. Your eye will be sore for about 3-5 days after the procedure. The eye will also appear bruised for around one week. The vision is typically not affected by the procedure. You can return to normal activities or work after 1-2 days but the eye will continue to heal for a period of 4-6 weeks and it is not unusual for it to be red (healing) during that time. There will be some antibiotic eyedrops and some antiinflammatory eyedrops to use regularly in the healing phase once the pad comes off.

4
check up

Check up

Your first check is usually 2-6 weeks after surgery depending on the size of the growth. During the checkup, the team will check the healing process and ensure that the graft is well positioned.

5

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 surgery

Safe

Our surgeons are experienced in performing the latest pterygium removal techniques including autograft with tissue glue or amniotic membrane transplant to minimise the risk of recurrence to <1%.

Fast

Pterygium surgery with tissue glue allows for fast recovery and a return to normal activities within 1-2 days.

Proven

Pterygium surgery has evolved significantly over the past few years with the surgery typically completed without the need for stitches which minimises discomfort and optimises the cosmetic appearance after surgery.

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:

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

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

Zeiss Lumera operating microscope with Callisto virtual guidance system

The integral Callisto system in this microscope provides intelligent real time image guidance for incision and toric lens alignment for better management of astigmatism during surgery.

Intelligent Real Time Image Guidance

Tissue Glue

Artiss is a natural tissue glue with a fibrin sealant made which allows the surgeon to place the conjunctival autograft without the need to use stitches. 

Tissue Glue

Amniotic Membrane

Dehydrated amniotic membrane has been successfully employed in the surgical treatment of the many ocular surface diseases with over 1,000,000 cases over the past two decades

Amniotek

woman and man having a glass of wine over a cheese board

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 does pterygium surgery cost?

Pterygium surgery costs are usually covered by most insurance companies. Exact costs depend on whether you are having one or both eyes treated and the type of anaesthesia best suited for you.

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 :