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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

During cataract surgery a circular opening in the front facing capsule of the lens and then removes the inner nucleus. The remaining capsular envelope surrounds the new artificial lens which is typically injected in through the opening in the capsule. Over time the capsule shrinks and wraps around the new lens much like shrink wrap or cling film.

A common natural healing process after cataract or lens exchange surgery, occurs when the thin membrane behind the IOL becomes cloudy or wrinkled. This is called posterior capsule opacification (PCO) or secondary cataract.

PCO usually causes your vision to become blurry, hazy, or glarey again. YAG laser capsulotomy is a safe, in office procedure that permanently clears PCO and improves your vision. It involves using a special laser (YAG laser) to make a small opening in the cloudy membrane, allowing normal light to reach your retina. Treatment only takes a few minutes, is painless and quickly restores your vision to it’s previous clarity.

As PCO only occurs on some but not all cataract patients, it is not included in the price of cataract surgery and has a separate fee (covered by all insurance companies).

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 :

Assessment

Assessment

Your doctor will examine your eyes after instilling dilating drops. If you are found to have PCO then the YAG laser treatement will be offered and this can usually be completed on the same day.

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Surgeon sitting at computer by machine

On the day

You will be at Re:Vision for around one hour. Your eyes will be dilated prior to treatment. The procedure itself takes only 2-3 minutes and is completely painless.

2
Rest

Recovery

The recovery following YAG laser capsulotomy is rapid with no pain or discomfort. You can expect your vision to be a bit blurry and light sensitive after YAG laser due to your dilating eye drops. You may prefer a driver to take you home. The next morning you can expect improved vision. You may experience black spots in your vision for a few days but these typically settle with time.

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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)

YAG laser benefits

Comfortable

YAG capsulotomy is a quick and comfortable procedure, and the recovery is fast and painless.

Safe

We use the very newest YAG laser technology available in New Zealand to provide unequalled safety, care and quality of vision.

Proven

YAG laser has been around for decades, with millions having had safe and successful treatment.

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:

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

Ellex Ultra Q Reflex (YAG)

The Ultra Q Reflex™ YAG laser device allows for a full range of anterior and posterior YAG laser procedures, including capsulotomy, laser floater treatment or laser vitreolysis with the highest standards of safety, accuracy and efficacy. The device featues an Ultra Gaussian beam profile, which focuses more power into the center of the beam profile. This allows for delivery of greater energy density, which reduces the energy levels required to complete the treatment.

Modern YAG laser

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 YAG capsulotomy cost?

YAG capsulotomy costs are usually covered by most insurance companies.

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

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