Dr Nick Andrew, Iris Surgeon
Dr Nick Andrew has a special interest in
Iris Surgery, Iris Repair and Dislocated Lenses
Dr Andrew was personally trained by the highly experienced Dr Ike Ahmed in Toronto, who, in 2020, was ranked as the second most highly rated ophthalmologist in the world. Dr Andrew undertook the prestigious GAASS Fellowship in Toronto with Dr Ahmed.
Dr Andrew is a specialist eye surgeon with particular expertise in:
Iris surgery and iris repair including iris prostheses
Intraocular lens (IOL) exchanges
Dislocated lenses (including dislocated cataracts)
Each surgical technique has its own advantages and considerations. The specific operation recommended for you will depend on your situation.
Iris surgery and iris repair, including with artificial iris prostheses
Iris injuries can be repaired with either iris suturing (pupilloplasty) or artificial iris prostheses (Morcher aniridic iris segments and Human Optics iris prostheses). Dr Andrew is proficient in both of these operations.
There are numerous surgical techniques for repairing iris defects and each has its specific advantages and considerations. Having detailed knowledge of each technique can improve patient outcomes.
Dr Andrew performs pupil cerclage iris suturing, partial pupil cerclage, and iris repair withinterrupted sutures. He performs the surgery with intraocular microinstruments and McAhmed suture knots, Seipser knots, and intraocular tying. The key to achieving the best possible result is a delicate touch and highly rehearsed technique.
Iris injuries can be very disabling due to the dramatic light sensitivity and cosmetic problems that they cause. Fortunately, the results of iris repair (pupilloplasty) in typically presenting patients have shown to be very effective.
Above is an artificial iris prosthesis made by HumanOptics. Each implant is hand crafted in Germany to precisely match the colour and detail of the fellow (normal) iris. High resolution images of the normal iris are sent to HumanOptics and an identical prosthesis is manufactured and shipped within 6 weeks. Read more about HumanOptics artificial iris implants here. Photograph courtesy of HumanOptics.
Above left: dislocated cataract and dilated irregular pupil following trauma.
Above right: The immediate post-op appearance following cataract surgery using Morcher capsule hooks, capsular tension ring, and iris cerclage pupilloplasty (iris suturing).
Above left: Cataract and dilated irregular pupil following an acute angle closure glaucoma attack.
Above right: The immediate post-op appearance following cataract surgery, minimally-invasive glaucoma surgery using iStents, and pupilloplasty (iris suturing) with adjunctive iris cautery. In addition, I performed goniosynechiolysis to remove adhesions of iris from the drainage channels and endocyclophotogonioplasty (endoscopic laser probe) to widen the patient’s narrow drainage angle. The pigmented areas around the pupil margin fade post-op.
Lens exchange and repair of dislocated intraocular lenses
The lens of the human eye is suspended in place place by delicate fires called zonules. These are like tiny guy ropes that hold the lens in place. They can become weak from eye trauma, from old age, from previous traumatic cataract surgery, or as a result of medical conditions affecting the eye.
In suitably presenting patients with disclocated lenses, Dr Andrew can either re-fixate the lens that is already inside the eye to the iris or sclera. This can be done using either Gore-Tex suture, or Prolene (plastic) suture. Alternatively, he can exchange the dislocated lens for a new lens.
Intraocular lens dislocation and its repair
Above: This patient presented with a dislocated intraocular lens causing loss of vision. These are eye ultrasound images before and after the lens was repositioned to the sclera using 7-0 GoreTex sutures. Vision was restored that same day and the patient did well.
For all appointments and enquiries, please contact
Sight Specialists, Gold Coast.