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Exploring Minimally Invasive Glaucoma Surgery (MIGS)

Glaucoma is a chronic and progressive eye condition that’s also the leading cause of blindness in the world. Damage occurs as intraocular pressure (IOP) builds, which harms the optic nerve, causing irreversible vision loss. Traditional glaucoma treatments usually involve topical medications or laser treatments, the latter of which are associated with challenges like complications, long recovery times, and significant follow-up requirements.  

Fortunately, newer procedures are proving effective at addressing IOP in glaucoma patients, and they can involve less risk when compared to some traditional alternatives. Minimally invasive glaucoma surgery (MIGS) is a cutting-edge approach that’s proving highly effective, and it’s potentially safer than some other forms of treatment. Here’s what you need to know about MIGS.  

What Is Minimally Invasive Glaucoma Surgery?  

MIGS is a group of glaucoma surgeries that use minimally invasive approaches to reduce IOP. Typically, they involve a small incision and subsequent procedures to improve fluid drainage, leading to far less intraocular pressure.  

While MIGS can’t reverse any damage caused by glaucoma, the treatments can slow or prevent progression. The procedures typically decrease IOP substantially over periods of up to two years. Plus, they can reduce a patient’s need for glaucoma eye drops, making the condition easier to manage daily. 

Types of MIGS  

There are several MIGS procedures currently available. Here is a brief overview of them:  

  • Ab-Interno Canaloplasty (ABiC): A MIGS procedure that uses a microscopic incision and the insertion of a catheter into the drainage canal to inject a viscoelastic substance that breaks down blockages and adhesions to improve fluid drainage  
  • CyPASS: A MIGS procedure involving an implanted device that’s positioned in the suprachoroidal space to enhance fluid outflow  
  • Gonio-Assisted Transluminal Trabeculotomy: A MIGS procedure similar to ABiC that’s particularly well-suited to younger patients with juvenile glaucoma  
  • iStent: A MIGS procedure using a small implant that’s placed in the drainage angle to improve fluid outflow  
  • Trabectome: A MIGS procedure for treating open-angle glaucoma that involves a small incision and a specialized tissue debris-removal tool to address fluid drainage blockages.  

The Benefits of MIGS  

MIGS procedures offer patients an array of benefits. Generally, MIGS is far safer than traditional glaucoma surgery, using smaller incisions and coming with a reduced risk of complications. Each of the MIGS procedures also minimally alters normal anatomy and instead focuses on augmenting physiological systems to improve outflow.  

With a MIGS procedure, IOP is typically reduced significantly, though the exact amount can vary. In many cases, patients can reduce their use of eye drop medications after a MIGS procedure. Recovery is also far quicker when compared to many traditional surgical alternatives, resulting in less downtime for patients.  

Is MIGS Right for You?  

Generally, MIGS are potential treatments for patients with mild or moderate glaucoma who either aren’t getting positive results with topical medications or who don’t tolerate those treatments well. The use of the implants reduces the need for topical medications, making them a strong choice in situations where medications prove ineffective or lead to undesirable or hard-to-manage side effects.  

However, only an eye care provider can determine if you’re a good candidate for MIGS. Additionally, there are several MIGS procedures available, and some may better suit your situation than others.  

At ECVA, the safety and health of our patients’ eyes are our priority. If you’re considering MIGS as a treatment for glaucoma or simply haven’t visited your eye care provider in the past year, the ECVA team is here to help. Schedule an appointment at your closest ECVA clinic today.