SLT - The Gentle Glaucoma Treatment
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SLT - The Gentle Glaucoma Treatment
Experience Clearer vision with advanced, personalized laser eye surgery tailored to your unique needs.
Glaucoma Brochures in English and Mandarin:
Download our LASIK brochure to discover how laser vision correction works, who it’s suitable for, and why thousands have trusted Re:Vision for clearer, sharper vision.
What is LASIK ?
Selective Laser Trabeculoplasty (better known as SLT) is a painless, effortless and quick procedure that is performed at our rooms.
SLT is successful at reducing high intraocular eye pressure whilst releasing you from the lifestyle weight of glaucoma medications and their side effects.
How does SLT work?
SLT uses short pulses of low-energy light to target the melanin, or pigment, in specific cells of the eye. This stimulates the body's natural healing mechanism to improve drainage and lower eye pressure, and in almost call cases it is very effective.
This rebuilding process improves drainage and lowers eye pressure.
Who is best suited for SLT?
SLT is a great treatment option for you if you have raised eye pressure (ocular hypertension) or glaucoma, especially if you find drops bothersome, uncomfortable or difficult to administer or remember.
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
Your personalised glaucoma appointment will take 30-60 mins. Our team will examine the eye and provide you with any additional information. Eyedrops will be administered to prepare the eye for the laser procedure.
Meet your surgeon
Dr Perumal is a fellowship trained glaucoma surgeon with over 10 years of experience in performing SLT.
During the procedure, a specialised contact lens is placed on the eye which will help keep the eye still.
Then, gentle pulses of light are delivered through a specially designed microscope. The entire process takes just a few minutes and is usually well tolerated.
We will advice you on any post procedure drops and if you should continue your current glaucoma drops.
Recovery
There are no restrictions on your activities after laser treatment and most patients return to work the same or following day.
You may find your vision blurry for a couple of hours after the laser. You may also have mild discomfort, redness and blurred vision for a few days following the procedure, generally subsiding in 5-7 days. Topical non steroidal anti inflammatory drops may be used to reduce discomfort.
Follow up
We will typically see you again 4-6 weeks following laser to assess the effectiveness of the laser.
SLT is effective in 70% of patients. In the patients where there is a response to SLT, the effect of SLT can last many years (on average 3-4 years), but may begin to wear off after 12-18 months. SLT can be reapplied in patients safely in all stages of glaucoma.
5 most common reasons patients have LASIK eye surgery :
Improved Vision :
LASIK can significantly improve high definition vision, allowing people to see clearly without relying on glasses or contact lenses. This is a huge benefit for people who’ve been struggling with poor vision for years.
Convenience :
For those always on the go or have an active outdoor lifestyle, a life not limited by glasses or contacts is a huge lift.
Cost Savings :
Over time, the cost of glasses and/or contact lenses, all add up. LASIK is a very cost-effective solution to reduce long-term expenses related to vision correction.
Safety :
With advances in laser technology, the small risks associated with LASIK have become increasingly minimal. Risks are minimised by choosing an experienced specialist laser surgeon who uses the latest laser technology.
Improved Self-Confidence :
For many, wearing glasses or contact lenses can be a source of self-consciousness. LASIK helps to improve self-confidence and allow people to feel more comfortable in their own skin.
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
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
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- 876.6 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)
Invested in Your Glaucoma Care
Effective
In a landmark study, SLT provided better eye pressure control, a greater chance of being medication-free, and reduced the risk of glaucoma deterioration and need for surgery compared to eye drops.
Fast
It only takes 5 minutes to conduct this painless procedure
Rapid recovery
Most patients return to work after the procedure. Some patients will feel some discomfort which is treated with eyedrops.
Safe
SLT can be repeated if necessary. There are no incisions made, and may help avoid further eye surgery. SLT specifically targets the pigmented cells in the drainage. The rest of the eye structure remains untouched.
Comfortable
Most patients do not feel any discomfort.
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.
World class gentle effective laser
SLT Machine
The Ellex Tango Reflex Neo SLT (Selective Laser Trabeculoplasty) machine is a sophisticated medical device used in ophthalmology for treating open-angle glaucoma. It involves using a laser to treat the drainage area of the eye (trabecular meshwork) responsible for regulating the eye's internal pressure by improving fluid outflow. The laser is applied in short, low-energy pulses to specific areas of the trabecular meshwork, aiming to increase drainage efficiency without causing significant damage to surrounding tissues.
The Ellex Tango Reflex Neo SLT machine provides precise control over the laser application, allowing ophthalmologists to target specific areas of the eye while minimizing damage to healthy tissue. This treatment option is often considered for patients with open-angle glaucoma as an alternative or adjunct to eye drops or surgical procedures. Selective Laser Trabeculoplasty can potentially reduce intraocular pressure and help manage glaucoma progression.
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What is Wavefront-Guided LASIK?
Wavefront-Guided LASIK is a highly customised form of LASIK surgery. It uses advanced technology to create a detailed 3D map of your eye's unique imperfections, similar to a fingerprint. This map then guides the laser to reshape your cornea with extreme precision, correcting not only common vision problems like nearsightedness, farsightedness, and astigmatism, but also microscopic irregularities that can affect vision quality.
Why Choose Wavefront-Guided LASIK?
Wavefront-Guided LASIK offers a more personalized treatment than traditional LASIK, aiming to provide superior vision quality. By addressing the unique "fingerprint" of your eye's aberrations, it can potentially result in sharper vision, improved contrast sensitivity, and a reduced likelihood of night vision disturbances like glare and halos.
How is WG-LASIK Different from SMILE?
Wavefront-Guided (WG) LASIK involves creating a flap in the cornea to reshape the underlying tissue with a laser. SMILE (Small Incision Lenticule Extraction) is a flap-less procedure where a small, lens-shaped piece of corneal tissue (lenticule) is removed through a tiny incision to correct vision. While both are effective, their surgical approaches and ideal candidates can differ.
Is LASIK right for me?
LASIK is suitable for many, but not everyone. Generally, ideal candidates are over 18, have stable vision, and have healthy eyes. A comprehensive eye examination with your surgeon is essential to determine if LASIK is the best option for your specific vision correction needs.
How long does the surgery take?
The actual laser treatment for each eye typically takes less than a minute. The entire procedure, including preparation, is usually completed within 15-30 minutes for both eyes.
Does LASIK surgery hurt?
LASIK surgery is performed with numbing eye drops, so you should not feel any pain during the procedure. You might experience some pressure or a sensation of coolness. After the surgery, some patients report mild discomfort, a gritty feeling, or tearing, which usually subsides within a few hours.
When can I drive or return to work?
Most patients experience significant vision improvement within 24 hours. You will not be able to drive immediately after surgery, so you'll need someone to take you home. Many people are able to drive and return to non-strenuous work within 1-2 days, depending on their individual healing and the nature of their job.
Can you guarantee me perfect vision with LASIK?
While LASIK has a very high success rate in achieving excellent vision, no surgeon can guarantee "perfect" 20/20 vision for every patient. The goal is to significantly reduce your dependence on glasses or contact lenses, and most patients achieve 20/20 or better vision. Your surgeon will discuss realistic expectations with you.
Is there an upper age limit for LASIK?
There isn't a strict upper age limit for LASIK, but suitability depends more on the health of your eyes than your chronological age. As people age, conditions like cataracts or presbyopia (age-related reading vision loss) can make LASIK less appropriate or mean that other procedures would be more beneficial.
Do I need to leave contact lenses out before surgery?
Yes, it's crucial to stop wearing contact lenses for a specified period before your LASIK consultation and surgery. This allows your cornea to return to its natural shape, as contact lenses can temporarily alter it, which could affect the accuracy of your measurements. Your surgeon will provide specific instructions, but it's typically 1-2 weeks for soft lenses and longer for hard or toric lenses.
How long will the correction last?
For the vast majority of patients, the vision correction achieved with LASIK is permanent. The changes made to your cornea are stable. However, LASIK does not prevent the natural aging process of the eye, so you may still develop presbyopia (requiring reading glasses in your 40s or 50s) or cataracts later in life.
Here are reasons our surgeons at Re:Vision see LASIK as a superior procedure to SMILE:
Precision
LASIK is auto-centred; SMILE is manual and and less accurate.
Vision Quality
LASIK offers high-definition vision; SMILE is less crisp.
Recovery Speed
LASIK recovers in days; SMILE takes weeks or longer.
Dryness Outcomes
Both procedures show similar dry eye symptoms by 3 months post-surgery.
Astigmatism Accuracy
LASIK corrects astigmatism more precisely than SMILE, thanks to auto-alignment.
Error Correction
LASIK treats 25 focus errors; SMILE treats only myopia and astigmatism.
Fine-Tuning
LASIK is easy to fine-tune; SMILE is harder and riskier.
Night Vision
LASIK provides better night vision thanks to a wider treatment zone and error correction
Surgeon Involvement
SMILE requires much more surgeon hand-held manipulation than LASIK.
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.
Frequently Asked Questions:
What are the risks?
SLT laser is a very safe procedure. It is extremely rare to have any visual problems. It is not uncommon to have some transient inflammation and pressure spikes following laser. These problems usually resolve on their own and can otherwise generally be treated if they do occur.
Are there any alternatives?
Medicated eye drops are an alternative form of treatment of open-angle glaucoma; however there are side effects, may not be effective and require daily use. Another alternative is to conduct intraocular surgery which are invasive and carry a risk of infection, bleeding and longer recovery.
How do I stop blinking during the procedure?
Do not worry, a special contact lens is placed on your eye during the procedure which will stop you from blinking.
Costs
At Re:Vision, all types of laser vision correction (LASIK or PRK) cost :$7,000
Glaucoma laser costs are usually covered by most insurance companies.
A detailed quote for your consultation will be provided prior to your consultation.
We will not charge you for any procedure unless discussed and your consent is obtained.
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 :$7,000
Get Started
Still have questions?
Get in touch with us and a friendly member of our team will assist.
We can also schedule your glaucoma consultation.
References :
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