Glaucoma surgery has evolved significantly in recent years, giving patients more treatment choices than ever before. The development of MIGS (minimally invasive glaucoma surgery) has provided an alternative to traditional surgical approaches.
Keep reading to learn how MIGS compares to traditional glaucoma surgery, including recovery times, effectiveness, and which approach might work best for your specific situation.
What Is MIGS?
MIGS stands for minimally invasive glaucoma surgery. These procedures use tiny incisions and specialized tools to reduce pressure inside your eye.
The goal is the same as traditional surgery: to prevent further damage to your optic nerve by lowering eye pressure.
During MIGS procedures, surgeons create new drainage pathways or improve existing ones to help fluid flow out of your eye more easily. When the fluid can flow freely, pressure decreases naturally. Most MIGS procedures take 15 to 30 minutes and can often be combined with cataract surgery.
How Does Traditional Glaucoma Surgery Work?
Traditional glaucoma surgery includes procedures like trabeculectomy and tube shunt surgery. These have been the standard treatment for advanced glaucoma for many decades and remain highly effective options.
During a trabeculectomy, your surgeon creates a small flap in the white part of your eye to allow fluid to drain into a space beneath the clear membrane covering your eye. This creates a new pathway for fluid to leave your eye, reducing pressure.
Tube shunt surgery involves placing a small drainage tube inside your eye, connected to a tiny plate positioned on the outside of your eyeball. The tube redirects fluid from inside your eye to the plate area, where your body naturally absorbs it.
These traditional procedures typically require larger incisions and longer recovery periods than MIGS. However, they often provide more significant pressure reduction and work well for patients with advanced glaucoma or those who haven’t responded to other treatments.
Comparing MIGS and Traditional Surgery
There are a few key differences between these approaches. Learning them can help you have more informed discussions with your eye doctor about your glaucoma treatment options.
Recovery Time and Healing
MIGS procedures generally offer faster recovery times. Most patients return to normal activities within a few days to a week. The small incisions heal quickly, and you’ll typically experience less discomfort during the healing process.
Traditional surgery requires a longer recovery period, often several weeks to a few months. Your eye needs more time to heal from the larger incision, and you’ll need to follow specific activity restrictions during recovery.
This might include avoiding heavy lifting or strenuous exercise for several weeks.
Surgical Risk Factors
MIGS procedures carry lower risks of complications compared to traditional surgery. The smaller incisions and gentler approach reduce the chance of infection, bleeding, or other surgical complications. However, like any medical procedure, MIGS still carries some risks that your doctor will discuss with you.
Traditional glaucoma surgery has a slightly higher risk profile due to the more extensive nature of the procedure. Potential complications can include infection, bleeding, or problems with the drainage system.
Despite these risks, these procedures have excellent long-term success rates when performed by experienced surgeons.
Effectiveness in Lowering Eye Pressure
In some cases, traditional surgery may provide greater pressure reduction than MIGS procedures. This makes traditional approaches better suited for patients with very high eye pressure or advanced glaucoma damage.
MIGS procedures provide more modest pressure reductions but are often sufficient for patients with mild to moderate glaucoma. The pressure reduction from MIGS may also help reduce your dependence on daily glaucoma eye drops.
Ideal Candidates for Each Approach
MIGS works well for patients with mild to moderate glaucoma who want to reduce their reliance on eye drops or need additional pressure-lowering beyond what medications can provide. It’s also excellent for patients having cataract surgery who want to address both conditions simultaneously.
Traditional surgery is often recommended for patients with advanced glaucoma, very high eye pressure, or those who haven’t achieved adequate pressure control with MIGS or medication.
Benefits and Considerations of MIGS
MIGS offers several advantages that make it appealing to many patients. The faster recovery time means less disruption to your daily routine and work schedule. You can typically resume most normal activities within days rather than weeks.
The lower complication rate provides peace of mind for patients who are concerned about surgical risks. The smaller incisions also mean less discomfort during and after the procedure.
Many MIGS procedures can be performed at the same time as cataract surgery. This combination approach allows you to address both vision problems in a single procedure, reducing the total number of surgeries you need.
However, MIGS has limitations you should understand. The pressure reduction may not be sufficient for advanced glaucoma cases. Some patients may still need to use glaucoma eye drops after MIGS, though often fewer than before. Additionally, if MIGS doesn’t provide adequate pressure control, you might eventually need traditional surgery.
When Traditional Glaucoma Surgery May Still Be Best
Traditional glaucoma surgery remains the preferred choice in several situations.
Patients with advanced glaucoma often need the greater pressure reduction that traditional procedures can provide. If your optic nerve damage is significant, your eye doctor may recommend traditional surgery to give you the best chance of preserving your remaining vision.
Previous surgical failures also influence treatment decisions. If you’ve had unsuccessful glaucoma procedures in the past, traditional surgery might offer better long-term results. Additionally, patients with very high eye pressure readings often benefit more from traditional approaches.
Your overall eye health and anatomy play a role, too. Some patients have specific eye conditions or structural features that make traditional surgery a safer or more effective option.
The experienced team at Eye Care & Vision Associates carefully evaluates each patient’s unique situation to recommend the most appropriate treatment approach.
Ready to learn more about your glaucoma treatment options? Schedule a comprehensive consultation at Eye Care & Vision Associates by clicking this link or calling 716.631.EYES (3937) to discuss which surgical approach might be best for protecting your vision and meeting your personal needs.