written or reviewed by
Lisa M. Tom, M.D.

Understanding Minimally Invasive Glaucoma Surgery (MIGS)

Glaucoma, often referred to as the “silent thief of sight,” is a group of eye disorders that can damage the optic nerve, leading to vision loss and blindness if left untreated. The condition is the leading cause of irreversible blindness worldwide, and it impacts millions of Americans.  Recent advancements in medical technology have paved the way for effective and less invasive treatment options, including Minimally Invasive Glaucoma Surgery (MIGS).

What is MIGS?

MIGS stands for Minimally Invasive Glaucoma Surgery or Microinvasive Glaucoma Surgery. MIGS procedures are characterized by less trauma to the eye and quicker recovery times compared to traditional, more invasive glaucoma surgeries. In general, they are less effective than traditional glaucoma surgeries in lowering pressure long-term, but have less risk of complications.

How Does MIGS Work?

MIGS procedures typically involve creating a tiny opening in the eye to improve the outflow of aqueous humor, the fluid that fills the front part of the eye. By enhancing the eye’s natural drainage pathways or creating new ones, MIGS help reduce the pressure inside the eye, which is crucial in managing glaucoma.

Types of MIGS Procedures

There are several types of MIGS procedures, each utilizing different approaches to improve fluid drainage and reduce intraocular pressure. Some common MIGS techniques include:

• Goniotomy: This procedure involves cleaning out the natural drain of the eye, enhancing fluid outflow.
• iStent and Hydrus Microstent: A tiny device is implanted in the trabecular meshwork, which is part of the natural drainage system of the eye, to improve outflow.
• Canaloplasty: This technique involves widening the eye’s drainage canal using a microcatheter.
• Cyclophotocoagulation: This procedure uses a laser to decrease production of fluid in the eye.
• Xen Gel Stent: This surgery involves creating a new outflow path for fluid from the eye through a stent.

MIGS offers several advantages over traditional glaucoma surgeries:

• Minimally Invasive: MIGS procedures involve less trauma to the eye, resulting in faster recovery times and reduced risk of complications.
• Lowered Intraocular Pressure: By improving fluid outflow, MIGS helps in reducing intraocular pressure, a critical factor in managing glaucoma.
• Reduced Dependence on Medication: For some patients, MIGS may reduce the need for glaucoma medications.

Is MIGS Right for Everyone?

While MIGS procedures offer promising benefits, they may not be suitable for all glaucoma patients. The suitability of MIGS depends on various factors, including the type and severity of glaucoma, the patient’s overall eye health, eye pressure, and specific medical considerations. It’s crucial to consult an experienced ophthalmologist who can assess individual cases and recommend the most appropriate treatment plan.

Minimally Invasive Glaucoma Surgery (MIGS) represents a significant advancement in the management of glaucoma. These procedures offer a less invasive alternative to traditional surgeries, providing hope for better outcomes and improved quality of life for individuals affected by this sight-threatening condition.

If you or a loved one are facing glaucoma, schedule an appointment with our glaucoma specialists to learn more about glaucoma treatment options and the potential benefits of MIGS. Early detection of glaucoma and timely intervention can play a pivotal role in preserving vision and maintaining eye health.