Minimally Invasive Glaucoma Surgeries (MIGS): A Modern Approach to Glaucoma Management
Understanding MIGS
This section explains what MIGS is and why it has become an important option in glaucoma care.
MIGS stands for minimally invasive glaucoma surgery, a group of procedures that lower eye pressure through small incisions and minimal tissue disruption.
High pressure can damage the optic nerve and lead to vision loss. By safely reducing pressure, MIGS helps slow glaucoma progression.
Who Benefits from MIGS?
MIGS is not for every patient, but many people with early or moderate disease gain meaningful relief.
Patients who are most likely to benefit share several characteristics.
- Primary open-angle glaucoma needing modest pressure reduction
- Difficulty tolerating or remembering daily eye drops
- Mild to moderate glaucoma seeking a safer alternative to traditional surgery
- Individuals having cataract surgery who want additional pressure control
If glaucoma is advanced and extremely low pressure is required, your doctor may recommend a more traditional incisional procedure.
Risks and Safety
Although MIGS is considered safe, every surgery carries some risk.
Possible issues include mild bleeding, temporary pressure spikes, or short-term inflammation.
Serious complications are rare, and overall risk is lower than with older glaucoma surgeries.
How MIGS Works
MIGS improves or bypasses the eye’s drainage system to lower pressure. Different techniques are used depending on each patient’s needs.
These implants create a direct pathway for fluid to reach Schlemm’s canal.
- iStent and iStent Inject
- Hydrus Microstent
Small sections of the trabecular meshwork are removed to enhance outflow.
- Kahook Dual Blade (KDB) goniotomy
- Trabectome
- Gonioscopy Assisted Transluminal Trabeculotomy (GATT)
These methods enlarge Schlemm’s canal and linked channels.
- VISCO360 or OMNI System
- Ab Interno Canaloplasty (ABiC)
Some devices redirect fluid to alternate spaces outside the normal drainage path.
- XEN Gel Stent
- Suprachoroidal approaches under investigation
Instead of improving outflow, certain procedures limit fluid formation.
- Endocyclophotocoagulation (ECP)
What to Expect During the Procedure
MIGS is typically performed in an outpatient setting and often paired with cataract surgery.
Local anesthesia numbs the eye so you remain comfortable throughout the short procedure.
The surgeon makes tiny cuts, inserts a device or performs a micro-technique, and confirms proper placement.
Most patients return home the same day and resume light activities quickly.
Recovery and Follow Up
Healing is usually swift, but ongoing care is vital to protect vision.
Mild discomfort or blurry vision is common for a brief time after surgery.
Anti-inflammatory and antibiotic drops help prevent infection and control swelling. Avoid strenuous activity until cleared by your doctor.
Regular visits allow your eye care team to monitor pressure, adjust medications, and address any concerns early.
Benefits and Considerations
MIGS offers several meaningful advantages while still requiring lifelong glaucoma monitoring.
Small incisions mean less tissue disruption and fewer complications.
Most patients return to normal routines sooner than with traditional surgery.
Many people can lower or even stop daily glaucoma drops after a successful MIGS procedure.
MIGS can be performed through the same incision used for cataract removal, providing dual benefits in one operation.
MIGS manages but does not cure glaucoma, so scheduled eye exams remain essential.
Frequently Asked Questions
Below are answers to common questions our patients have about MIGS.
No. MIGS involves tiny devices or micro-incisions, while laser procedures like selective laser trabeculoplasty use light energy without implants.
MIGS does not cure glaucoma. It lowers eye pressure to slow disease progression, and ongoing monitoring is still necessary.
Results vary, but many patients enjoy lower pressure for years. Because glaucoma is progressive, periodic follow-up ensures treatment remains effective.
Your doctor will check pressure at each visit, watch for complications, and adjust any medications. Some patients reduce or stop drops, while others continue on a lower regimen.
Partnering With Our Glaucoma Specialists
Our eye care team is dedicated to offering advanced options like MIGS to safeguard your vision. We look forward to guiding you through every step of treatment and providing the personalized care you deserve.
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