MIGS

Minimally invasive glaucoma surgery (MIGS) is a category of glaucoma procedures that can be safely performed at the time of cataract surgery. These procedures are designed to improve the eye’s natural fluid drainage system, helping to lower intraocular pressure. MIGS procedures have one of the lowest side-effect profiles among incisional glaucoma surgeries and are typically recommended for patients with mild to moderate glaucoma. Having MIGS does not prevent you from pursuing other, more advanced glaucoma treatments in the future if needed.

Procedure

This procedure adds only a few minutes to cataract surgery (total surgery time is approximately 20 minutes). It is performed under conscious sedation, meaning you are awake but relaxed. Some patients experience temporary blurring of vision after the procedure, which can be a normal sign that fluid is flowing more effectively through the drainage system. Most patients have little to no pain, though a mild, short-lived ache may occur.

FAQ

  • What is MIGS?

    Glaucoma treatments exist on a spectrum, from less-invasive but less-effective interventions to more-invasive but more-effective ones.  Minimally invasive glaucoma surgery is a new and rapidly-advancing field in glaucoma care designed to reduce eye pressure with less risk, faster recovery time, and fewer side effects than traditional glaucoma surgeries, while still maintaining good effectiveness. 

  • What are the different kinds of MIGS?

    There are many devices and techniques that fall in this category, and there are more options every year.  Most of them fall in one of these categories: 

     

    • Goniotomy: opening a section of the meshwork to allow more drainage through
    • Trabecular meshwork bypass stents: these tiny implants allow fluid to bypass the resistance of the meshwork without removing any tissue
    • Canaloplasty: designed to dilate the outflow channels beyond the trabecular meshwork
  • Who is MIGS for?

    Most often, these procedures are combined with cataract surgery for patients who have both glaucoma and a cataract.  That way, both problems can be addressed with a single trip to the operating room, and the same incisions that are used to remove a cataract can be used to do the MIGS procedures.  MIGS procedures are also sometimes used on their own, and can be particularly effective for patients with specific types of glaucoma such as pseudoexfoliation glaucoma, pigmentary glaucoma, or steroid-induced glaucoma.  

  • Which MIGS procedure is right for me?

    This depends on a number of factors: the anatomy of the patient’s eye, the preoperative pressure, and the target pressure.  Your surgeon can explain your options in the context of your eye and its specific needs.