Tamar Tsirekidze’s „Open Sky Surgery

It is under a microscope that the real magic unfolds several times per day. The participants of the ophthalmic surgery include a surgeon, patient, and a microscope. The movements need to be precise and careful. She makes the decisions all by herself, and says that it is impossible to suffer from fatigue when you know that you possess the art of returning the light to people; providing them with a newfound joy of life, along with improved sight.

Doctor Ophthalmologist and Eye Surgeon Tamar Tsirekidze has been performing the most challenging surgeries for years. About a month ago, she was the first surgeon in Georgia to perform the unique femtosecond laser-assisted sutureless intrastromal corneal transplantation surgery.

She says that her career choice is as precise as possible. Time and again, life confirms the accuracy of her choices as she successfully completes one difficult surgery after another. After each surgery, as a rule, she takes a few minutes to be all by herself, soaks in the mixed emotions of victory, pride, and joy.

Between surgeries, she welcomes her patients. Every working day is busy from morning to evening: consultations, tests, surgeries. She personally knows each and every patient, remembers all of their personal histories and says that along with professionalism, the main secret that enables her to perform the most difficult surgeries in modern ophthalmology is loving the people.

To be more precise, she makes miracles happen.

Photo: Ana Boko for Forbes Woman Georgia

Let’s begin with talking about the unique surgery that you were the first to perform in Georgia this year.

Many years of surgical experience, knowledge accumulated over the years and, I would say, courage as well, brought me to perform the first-ever femtosecond laser-assisted sutureless intrastromal corneal transplantation surgery in Georgia. This is one of the highest achievements in the field of ophthalmology, a great help for Georgian patients.

No less impactful was the laser-assisted corneal transplant surgery, which is also rather interesting because only a few surgeons in Georgia can perform it and you are the only female surgeon among them. What does this particular surgery entail?

Corneal transplantation is one of the biggest challenges for a surgeon. I did the training to perform this particular surgery in Barcelona, Spain. When I attended corneal transplant surgeries performed by my colleagues, I felt as if God himself was doing it through human hands. The surgery involves the preparation of the donor and recipient corneas.

We have partnered up with the Eye Bank Association of America and we get donor cornea from them. The minutes filled with the most responsibility is when the surgeon opens up the patient’s cornea and starts working on an open eye. The ophthalmologists call it “open sky” surgery. Even the smallest extra movement can result in the possible loss of an eye.

Surgeries are performed both manually and with the assistance of a Femto Laser. This depends on the degree of damage to the patient’s cornea. Corneal transplantation using a Femto Laser is one of the biggest innovations in the field of ophthalmic surgery. Incisions are made by the laser. Thanks to its precision, the process of fitting the donor cornea is made easier and the surgery can be completed using fewer sutures, which significantly reduces the risk of postoperative astigmatism and gives a higher quality of vision.

How often is there a need for transplantation and what are the difficulties associated with the rehabilitation process?

I perform up to 40 different types of surgeries a week, but, fortunately, the need for transplants is not very frequent. This means that preventive medicine is at a very high level, which has been made possible thanks to the development of diagnostic studies, raising the level of qualification of doctors.

The post-transplant care period can prove to be quite difficult. There are a lot of factors that can complicate the rehabilitation process. A simple cold, fatigue, spending a lot of time in front of the computer screen, spending too much time in the sun – every one of these things is a risk factor and the patients need to be extremely cautious in the first 6-8 months post-op period. Therefore, doctors need to observe and monitor the patient carefully.

Photo: Ana Boko for Forbes Woman Georgia

What is the range of eye problems that you help solve? What methods do you work with and what are your results in this particular direction?

We offer patients refractive surgery methods such as Femto laser correction of vision, phakic intraocular lens implantation, refractive phacoemulsification, allowing the correction of refractive errors from -20.0 D to + 20.0 D, correction of high-grade astigmatism. Full range of surgical treatment of keratoconus, cataract surgery.

If you only knew what a joy it is to meet with patients the day after the procedure, when they are able to see the world without glasses. The eyes that previously had trouble seeing, look completely different post-op. It is a very special moment when an elderly patient gives you hugs and blessings. This is when you forget about all the fatigue you have endured, spending hours and nights on end in the operating room. The greatest reward is when the patient looks at you and says, “I see you, doctor!” This is what keeps me going and makes me think that I have made the right career choice.

What is the main challenge in your career and what do you consider to be the main victory?

The peculiarity, difficulty and, at the same time, incredible adrenaline-inducing experience in my profession is that you work independently, without an assistant surgeon. Thus, you have to deal with all the unexpected circumstances and ramifications all by yourself.

I believe that both professional and personal development is a non-stop, continuous process that allows you to create a better version of yourself. I always try to set a new goal, and not just stay complacent with what I have achieved. From a professional point of view, I am actively working to introduce innovations, I regularly attend international conferences, participate in congresses organized by the Georgian Association of Ophthalmologists and share my experiences with colleagues.

During the pandemic, I was involved in online consultations for immigrant citizens along with doctors from other fields. I also consider it a great experience to have performed 100 cataract surgeries in Jaipur, India. I have extraordinary residents, some of whom have already become very good doctors and I am so incredibly proud of them. Moreover, I am working on my Ph.D.

Photo: Ana Boko for Forbes Woman Georgia

What were your first steps?

I graduated from the Medical Faculty of Tbilisi State Medical University, and then completed my residency in ophthalmology. During my residency, I received scholarships from the European Association of Ophthalmologists twice, and took courses at the University Clinic in Mainz, Germany, first in refractive surgery and then in corneal surgery. I later participated in the American Ophthalmologists Association program. I lived with the family of the President of the American Ophthalmologists Association and with him, received patients at the New Orleans Regional Clinic. I’d like to thank all the professors who have provided their unwavering support as I was taking my very first steps.

All three of these scholarships played an important role in shaping the direction in which I was to continue my work. I attended international conferences, I was always learning about the innovations, but the practical experience opened up new doors of opportunities for me.

How difficult was the path you have taken so far?

After completing my residency, I started working at the National Center for Ophthalmology. Doctors, not surgeons, stayed there on overnight shifts. The surgeon would only go in when a difficult case was presented. So I took one shift a month, then two. Then I slowly took on the full load. I was on night shifts 8 nights a month across the whole country. There were no other round-the-clock ophthalmic services available. Any big or small trauma – falling from heights, burns, getting something in the eye – patients with these injuries were brought in from all over the country to the clinic, which was an astounding experience.

One may retire not having experienced such a wide range of injuries in their practice. That is why I always say that I have been very lucky to have been given the opportunity to be actively involved in the night shifts that involved working on all kinds of injuries: from mono-eye to combined trauma, which required working with neurosurgeons and maxillofacial surgeons.

The patients were people who have suffered a trauma that had forever altered their lives in a split second. You feel a huge responsibility as it is not enough to just be an ophthalmic surgeon. You are also there to help them psychologically. I have many patients who have suffered from injuries in their childhood, and I have watched them grow up. It is with them that the feeling of joy becomes bigger when you see your achievements in their eyes.

I work in traumatic surgery to this day and I think that if a future surgeon does not have experience working in urgent, unplanned, traumatic surgery, they cannot be bold in their own future decisions. Boldness and courage come with time. Practice bought me these qualities at a very young age.

Photo: Ana Boko for Forbes Woman Georgia

Are you courageous?

Yes, very much so. My attitude has been always this: if someone somewhere can perform a particular surgery, then why can’t I do it just as well? What deters me from doing the same? What could be holding me back? I have the experience, knowledge and the technical support. The New Hospitals Ophthalmology Center, where I currently perform surgeries, has a 128-year tradition of treating eye diseases.

The hospital is equipped with high-tech equipment and is a leader in the field of prevention, diagnosis and treatment of eye diseases. The state of the art equipment of the hospital provides accurate and quick diagnostic and surgical services. Eye parameters are determined using ultra-modern technologies. A flawless digital image of the eye is obtained, which helps determine the optimal treatment tailored to each patient’s needs.

National Center for Ophthalmology offers a full range of ophthalmic services and is the only center in the whole of Transcaucasia that has been recognized by Carl Zeiss AG and the German Economic Development Council as the Center for Transcaucasian Regional Refractive Surgery.

How do you unwind and spend your free time?

My greatest passion is the paintings by contemporary Georgian artists. I never miss an opportunity to attend exhibitions. I dare call myself a modest collector. The pleasure that art and creativity give me is a new, additional source of energy for me. I own paintings by famous Georgian artists and I am proud to say that my collection includes my own portrait created by Piko Nizharadze, which I consider a special honor and an invaluable gift.

Another major hobby and best way to unwind for me is drifting. Speed, adrenaline and the risk give me a feeling of complete freedom, which, in turn, gives rise to new ideas.

Who or what motivates you? What is the recipe for success?

Both the secret and the recipe to success lay in the constant pursuit of support and purpose. The role of my Georgian top professors and colleagues in shaping and developing me as an eye surgeon is invaluable. I am grateful to my parents who did their best to get me an education and to be who I am. Thanks to my husband and children who have been so supportive of me and, of course, to my friends who have faithfully supported me throughout my life.

I always thought there was no such thing as an unattainable goal. The work that you put your heart and soul into quickly becomes the victory over your own self. If you convert your personal success and victory, you will see people that with your help, now live a better life – this paves the way towards brand new goals.