All about minimally invasive glaucoma surgery

In this article below, experienced and highly skilled consultant ophthalmologist, Miss Anna Mead, explains what MIGS is, describes how this surgery is normally performed, and details what patients can expect after the surgery.

What is minimally invasive glaucoma surgery?

Minimally invasive glaucoma surgery (MIGS) is a group of various different surgeries used to treat glaucoma.

How is it performed?

MIGS sees the ophthalmologist insert tiny incisions in the patient’s eye. This reduces trauma to ocular tissues.

The surgery is performed using various techniques, with each one designed to improve aqueous outflow and reduce intraocular pressure (IOP). So, how is MIGS performed? Well firstly, the patient is positioned appropriately, and local anaesthesia is administered. Then, a small corneal or scleral incision is made, which allows the surgeon to gain access to the anterior chamber of the eye.

What are the different types of MIGS?

There are many types of minimally invasive glaucoma surgery. They are:

1. Trabecular meshwork bypass: Microstents (e.g., iStent, Hydrus) are inserted into the trabecular meshwork to enhance aqueous drainage.
2. Schlemm’s canal procedures:Devices like Visco 360/OMNI or Ab Interno Canaloplasty (ABiC) are used to dilate Schlemm’s canal.
3. Suprachoroidal space procedures:The CyPass Micro-Stent is placed to redirect fluid into the suprachoroidal space.
4. Subconjunctival shunts: The XEN Glaucoma Implant facilitates drainage into the subconjunctival space.
5. Ciliary Body Ablation: Endocyclophotocoagulation (ECP) uses laser energy to reduce aqueous production.

Whichever the specific procedure, the incision in the eye is closed using sutures or self-sealing techniques.

What does post-operative care following MIGS entail?

Patients receive instructions for eye care, including antibiotic and anti-inflammatory eye drops. Regular follow-up visits monitor IOP and healing. MIGS procedures typically have shorter recovery times compared to traditional glaucoma surgeries.

What conditions is MIGS suitable for?

This minimally invasive glaucoma surgery is suitable for mild to moderate glaucoma cases.

If you’d like to make an appointment for an eye concern that you might have with Miss Anna Mead, then you can do so via her Top Doctors profile today.