Minimally Invasive Glaucoma Surgery (MIGS) offers a modern approach to glaucoma management, focusing on lowering eye pressure with minimal recovery time. Discover how MIGS can enhance your eye health.
Glaucoma is the leading cause of irreversible vision loss, and controlling intraocular pressure (IOP) is crucial for preserving your sight. Our glaucoma specialists have increasingly turned to MIGS to help bridge the treatment gap for patients whose IOP remains elevated despite eye drops or laser therapy. MIGS procedures are tailored to improve drainage through the eye’s natural systems while reducing reliance on medications.
MIGS procedures are distinguished by a set of core characteristics that make them less disruptive than traditional surgery. They offer a high safety profile with much lower risks of complications such as hypotony, choroidal hemorrhage, and infection. By preserving the normal anatomy of the eye through small incisions and a specialized approach to reduce pressure by enabling a more natural restoration of fluid drainage.
In essence, MIGS focuses on achieving meaningful reductions in IOP—typically around a 20% drop—with minimal surgical trauma. This category of surgery is broadly divided by the mechanism used to facilitate aqueous outflow or reduce the production of fluid in the eye.
Minimally Invasive Glaucoma Surgery (MIGS) is designed to lower eye pressure by improving how fluid drains from the eye. In glaucoma, high intraocular pressure (IOP) occurs when the eye’s natural drainage system doesn’t work efficiently, leading to potential damage to the optic nerve. MIGS procedures help relieve this pressure in a way that is safer and less invasive than traditional glaucoma surgeries.
Unlike older surgical techniques that create entirely new drainage systems, MIGS works by enhancing or modifying the eye’s existing drainage structures. The goal is to either improve the flow of aqueous humor (the fluid inside the eye) through natural pathways or, in some cases, reduce the amount of fluid the eye produces.
The trabecular meshwork is a spongy tissue that helps drain fluid from the eye into Schlemm’s canal, which then carries the fluid out of the eye. In glaucoma, this area can become blocked or resistant to fluid movement, raising eye pressure. MIGS procedures can improve this function by:
Schlemm’s canal is a circular drainage channel in the eye that helps carry fluid out of the trabecular meshwork and into the bloodstream. Some MIGS procedures focus on expanding this canal to enhance drainage, including:
When the eye’s natural drainage system is too impaired to function properly, some MIGS devices create alternative routes for fluid to exit the eye. These include:
Instead of improving drainage, some MIGS procedures focus on reducing the amount of fluid the eye produces. One technique, called endocyclophotocoagulation (ECP), uses a laser to treat the ciliary body—the part of the eye responsible for fluid production. By gently reducing its activity, the eye produces less fluid, helping to lower pressure.
Take the first step towards better eye health. Find a top optometrist or ophthalmologist near you who specializes in MIGS today!
The trabecular meshwork is the primary site of resistance within the eye’s drainage system. MIGS devices that target this area help create a direct pathway for fluid to flow into Schlemm’s canal. Two key examples include:
In addition to stents, there are surgical approaches that remove or excise portions of the trabecular meshwork to create a larger drainage opening. These procedures have the advantage of not leaving behind an implant, which can be beneficial in preserving the eye’s anatomy for the future.
Some MIGS approaches focus on enhancing the natural canal structure itself, without major tissue cutting. These procedures involve cannulating Schlemm’s canal, followed by the controlled injection of viscoelastic material to expand the canal and distal collector channels.
For some patients, bypassing the conventional drainage system may be preferable. These techniques redirect aqueous humor to spaces outside the natural drainage pathway:
Another method to lower intraocular pressure is by reducing the production of aqueous humor. Instead of enhancing drainage, these procedures target the part of the eye responsible for fluid production:
When our glaucoma specialists evaluate candidates for MIGS, they look closely at the severity of glaucoma and the individual’s eye anatomy. MIGS is particularly beneficial for patients with mild to moderate glaucoma who have either not found relief with medications or struggle with compliance. Those undergoing cataract surgery may also experience additional benefits when MIGS is performed concurrently.
Ideal candidates typically include:
However, in cases where glaucoma is more advanced and achieving a very low IOP is critical, traditional incisional surgeries might still be recommended. Our glaucoma specialists work closely with each patient to tailor the treatment strategy to their unique needs and ensure optimal safety and effectiveness.
Take the first step towards better eye health. Find a top optometrist or ophthalmologist near you who specializes in MIGS today!
Enhance your eye health with Minimally Invasive Glaucoma Surgery (MIGS) to effectively manage eye pressure and preserve vision.
