Minimally Invasive Glaucoma Surgery (MIGS)

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What is MIGS?

  • MIGS (Minimally Invasive Glaucoma Surgery) is a new surgical technique to treat glaucoma.
  • MIGS aims to lower intraocular pressure (IOP) in a safer and less risky way than traditional glaucoma surgery (trabeculectomy or tube implant).

MIGS Procedure Type:

  • Improving Trabecular Flow: Using devices such as the iStent or Trabectome
  • Utilizing the Suprachoroidal Pathway: Using a shunt like CyPass
  • Forming a Conjunctival Bleb: Using tools such as Xen Gel

à Generally aims to improve the flow of ocular fluid so as to control eyeball pressure.

Advantages of MIGS:

  • Recovery time is faster than traditional surgery.
  • Lower risk of complications, such as infection or severe bleeding.
  • Increases the flow of eye fluid to reduce pressure in the eye.

Duration of Operation

  • MIGS surgery generally takes about 30 minutes.
  • It is usually performed under local anesthesia, but general anesthesia may also be used under certain conditions.

Success Rate and Complications

  • Success Rate: Studies show that the iStent and XEN Gel Stent have an 80-90% success rate in eye pressure control. Most patients are able to reduce the use of eye drops after surgery, although some may still require them.
  • Complications: Rare complications include bleeding within the eye, infection, excessively high or low eye pressure, inflammation, and vision changes such as astigmatism or cataracts. These complications are usually rare and can be resolved with medication or additional surgery if needed.

Postoperative Care

  • Eye Drops: Post-surgery eye drops are usually antibiotics and anti-inflammatory steroids, which should be used for the first month after surgery.
  • Postoperative Control: Routine check-ups are done every two weeks during the first month after surgery but depending on the patient's eye condition, the frequency of visits generally decreases thereafter.
  • Activity and Care Instructions: Avoid strenuous activities, sports, and swimming for 1 month after surgery, do not rub or squeeze the eyes, and use eye protection in dusty environments.

Is MIGS for you?

  • MIGS is more suitable for people with mild to moderate glaucoma.
  • Not as effective as traditional glaucoma surgery especially for severe glaucoma.
  • Consult your eye doctor to see if MIGS is the right choice.