In our clinics located in South Australia, we offer non-admission laser treatment alternatives for glaucoma, eliminating the need for day surgery. The procedure is performed using topical anaesthesia eye drops, ensuring minimal to no discomfort throughout the treatment. The available alternatives include:

• Selective laser trabeculoplasty (SLT): This is performed for open-angle glaucoma. The technique involves directing laser pulses towards the drainage outflow channels, stimulating cellular activity to clear debris and enhance fluid outflow. This effectively reduces intraocular pressure. SLT is an extremely safe procedure; however, its effects may diminish over time.
• YAG laser peripheral iridotomy: This method is employed for angle-closure glaucoma. It entails creating a small opening in the iris (the coloured part of the eye). This opening helps widen the drainage angle and reduces the risk of disease progression. Alternatively, if you have co-existing cataracts, a cataract surgery may be performed as it opens the drainage angles and lowers eye pressure at every phase of the disease. Cataract surgery has been found to be a more effective treatment for acute angle-closure glaucoma.

Following your initial consultation, your specialist will provide recommendations on the laser treatment option that best suits your eye health and will run through the cost with you.

Micro-invasive glaucoma surgery (MIGS), also known as minimally invasive or micro-bypass surgery, is a specialised category of surgical treatments aimed at managing mild-to-moderate cases of primary open-angle glaucoma.

MIGS procedures involve the use of small incisions, similar to keyhole operations, and the delicate insertion of miniature medical devices into the eye’s drainage canal. This innovative technique enhances the outflow of fluid, reducing pressure on the optic nerve. MIGS procedures are highly regarded for their excellent safety record and speedy recovery time.

In Australia, the following implants have received approval for use:

• iStent inject^®: This consists of two tiny titanium stents, each measuring less than 0.4 mm. Using a preloaded injector, these stents are skilfully placed to bypass blockages in the trabecular meshwork, the eye tissue responsible for drainage, hence lowering intraocular pressure.
• Hydrus^®: This is a curved, flexible stent, approximately the size of an eyelash, that acts as a supportive scaffold. It is carefully positioned to bypass the trabecular meshwork and widen the natural drainage canal. This allows for increased fluid flow through the canal and into the collector channels, effectively reducing eye pressure.

MIGS procedures are generally only performed in conjunction with cataract surgery. The costs of the procedure will be discussed with you by your ophthalmologist.

Minimally invasive fluid diversion surgery (MIFDS), also known as MEBS, utilizes implants like XEN or Preserflo to redirect fluid into a small fluid blister called a “reservoir” located beneath the eyelid. This reservoir facilitates fluid drainage, leading to a reduction in intraocular pressure. MIFDS procedures provide a less invasive alternative with quicker recovery times compared to conventional glaucoma filtration surgery.

Traditional glaucoma relief surgery, also referred to as trabeculectomy, has a well-established history as a conventional treatment option for glaucoma.

This longstanding surgical procedure involves the creation of a specialised tunnel to circumvent the blockage that impedes fluid outflow. By establishing a new route, fluid can effectively drain from the eye into a small fluid blister known as a ‘bleb’ on the surface of the eye. To maintain the patency of the newly formed pathway, an anti-scarring agent called mitomycin C is utilised.

Glaucoma filtration surgery has demonstrated notable efficacy in managing the condition; however, it does involve a lengthier recovery period. Typically, this procedure is reserved for patients with moderate to advanced stages of glaucoma.

Intraocular pressure-regulating devices for glaucoma management, such as Baerveldt, PAUL, or Molteno implants, are purposefully crafted to effectively control pressure within the eye. These substantial implants feature a small tube that redirects fluid to a plate located beneath the upper eyelid. This surgical intervention is generally suggested for advanced glaucoma cases in situations where trabeculectomy is considered inappropriate or has not achieved the desired outcomes.

Public glaucoma treatments are covered entirely by Medicare, but there can be considerable wait times to access these services. On average, patients wait approximately 334 days to receive an elective surgery.¹

Private glaucoma treatments are covered partially by Medicare. The remaining cost can either be self-funded or paid through private health insurance. Private glaucoma treatments offer access to the latest advancements in glaucoma care, your choice of glaucoma specialist and booking flexibility for your appointments and treatment. There are also minimal wait times with private glaucoma treatment. But, there may be a waiting period for claim approval from your private health fund.

References:

1. Australian Institute of Health and Welfare (AIHW). Eye Health. AIHW;2021. Available at <https://www.aihw.gov.au/reports/eye-health/eye-health/contents/treatment-and-management> [Accessed online 9 November 2023].

Minimally invasive glaucoma surgery (MIGS) is one of the latest cutting-edge advancements available. MIGS is a highly precise micro-surgery where a tiny stent is inserted into the eye’s fluid drainage system (the trabecular meshwork). MIGS lowers eye pressure and can slow or halt glaucoma progression by improving fluid drainage within the eye.

We offer Hydrus^® and iStent inject^® MIGS technology at our Adelaide clinics. iStent inject^® is a recently developed glaucoma treatment and has only been available since 2014. iStent inject^® consists of 2 titanium stents less than 0.4 mm in diameter. Learn more about iStent inject^®.

Glaucoma Australia provides support for glaucoma patients. They host regular events and meet-ups, and provide national and congenital glaucoma-specific support forums.

Glaucoma Australia also offers a free patient support program called SiGHTWiSE that delivers free education and guidance.

Our Adelaide clinics offer selective laser trabeculoplasty (SLT) and YAG laser peripheral iridotomy glaucoma laser treatments.

The effectiveness of laser glaucoma treatment depends on the type and severity of glaucoma you have. The laser glaucoma surgeries we provide have rigorous international trials and clinical experience to support their use. In fact, SLT demonstrated a 25% decrease in eye pressure in 74–85% of patients.² However, the effects of laser glaucoma treatment can diminish over the years, in which case you may require additional laser surgery or alternative treatments. Book an appointment with one of our glaucoma specialists for glaucoma treatment recommendations best suited to you.

References:

2. Glaucoma Australia. Selective Laser Trabeculoplasty (SLT). Artarmon: Glaucoma Australia;2023:1-3. Available at <https://glaucoma.org.au/path-file/133>

All glaucoma patients are offered post-operative care appointments with their surgeon. Post-operative appointments allow your surgeon to examine your eyes and assess your recovery. Most patients also receive medicated eye drops to support eye healing.

Our glaucoma specialists provide these appointments at our Kurralta Park (Tennyson Eye Centre), North Adelaide and Windsor Gardens clinics.

Other post-operative care measures are dependent on the type of surgery and the individual patient. Book an appointment with one of our glaucoma specialists for tailored advice.

There are usually no waiting periods for private glaucoma surgery appointments. Typically, we can book your appointment within a week or so of your enquiry. Our private glaucoma clinics in Adelaide also offer access to the latest technologies and procedures, which may not be available at public glaucoma facilities. However, Medicare only partially subsidises the costs of private appointments and treatments. The remaining gap payment may be covered by private health insurance. By contrast, public glaucoma surgery appointments have lengthy waiting periods that may last months. Public appointments are entirely funded by Medicare and are free.

You will need a referral from a GP or optometrist to be eligible for a public glaucoma appointment or to receive the Medicare rebate for your private glaucoma appointment.

Book your glaucoma surgery appointment with one of our glaucoma specialists.

To find a bilingual glaucoma specialist, enquire with the individual clinic.

At our Vision Eye Institute Adelaide clinics, our glaucoma specialists offer multilingual services. Staff members at our North Adelaide and Windsor Gardens clinics can provide translation in Greek, Portuguese, Mandarin and Shanghainese. Staff at our Kurralta Park clinic can provide translation in Mandarin and Shanghainese.

If you require translation services in other languages, please advise us when you book your appointment so we can do our best to accommodate your request.