Minimally Invasive Glaucoma Surgery (MIGS)

MINIMALLY INVASIVE GLAUCOMA SURGERY (MIGS)

Glaucoma is an eye condition where the optic nerve which transmits the images we see from our eye to our brain becomes compromised, due to a build-up of pressure inside the eye. The aim of glaucoma treatment is to lower the pressure inside the eye and the first-line treatment for patients diagnosed with glaucoma is usually medical treatment in the form of topical anti-glaucoma eyedrops. If patients do not respond to the prescribed eye drops and the pressures are not lowered to the optimal level, then second-line treatments such as selective laser trabeculoplasty (SLT) or glaucoma surgery may be required.

Normal eye versus a glaucoma eye. Eyes with glaucoma have compromised or blocked drainage channels, resulting in a pressure build-up of fluid

A recent new class of surgery termed minimally invasive, microinvasive, or microincisional glaucoma surgery (MIGS) has been added to the treatment options of glaucoma. MIGS include several modern, microscopic devices that can be placed inside the eyes to lower the pressures with minimal or no disruption to the conjunctiva, with the aim of reducing or eliminating the need for glaucoma eye drops or invasive surgery. Trabecular Micro-bypass Glaucoma Surgery (MBGS), a form of MIGS, is commonly performed at the time of cataract surgery but it can also be performed as a stand alone procedure.

An implantable, flexible, nitinol metal tube with windows placed inside the eye to reduce pressure in glaucoma

What are the different types of MIGS?

There are a number of MIGS procedures available and they work in different ways in reducing the pressure build-up in the eye. If the natural drainage channels for the fluids inside the eye become blocked or compromised, an increase in the pressure inside the eye occurs, causing damage to the optic nerve. MIGS procedures work by bypassing the blockage and facilitate the fluid inside the eye to be drained out via different channels.

MIGS represent a significant advance in the treatment of glaucoma and is a safer option compared to the more complex and invasive trabeculectomy and glaucoma drainage devices. Your doctor will discuss the different options and use the most suitable device tailored to your type and severity of glaucoma.