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What exactly is Minimally Invasive Glaucoma Surgery (MIGS)?

Writer's picture: Mr Ahmad ElsahnMr Ahmad Elsahn

Updated: May 20, 2024

Minimally Invasive Glaucoma Surgery (MIGS) is an advanced surgical approach designed to lower intraocular pressure (IOP) and manage glaucoma more effectively. Unlike traditional glaucoma surgeries, MIGS procedures are less invasive, often leading to quicker recovery times and fewer complications.


Surgeons operating

Why is MIGS Performed?

Glaucoma occurs when fluid called aqueous humour builds up in the eye. This causes IOP to increase, which then damages the optic nerve and causes vision loss. The goal of MIGS is to improve the drainage of fluid from the eye, reducing elevated IOP and preserving your vision.


MIGS is typically recommended when conservative treatments like eye drops, laser therapy, or medications have not effectively managed your glaucoma or when you need additional pressure reduction.


Benefits of MIGS

The main benefit of MIGS is that it is minimally invasive, and uses small incisions or microscopic devices. This results in less trauma to the eye compared to traditional glaucoma surgeries.


This also means patients often experience quicker recovery times and less discomfort after MIGS procedures.


MIGS can reduce the need for glaucoma medications, leading to improved compliance and fewer side effects.


Types of MIGS Procedures:

There are several MIGS techniques, each tailored to specific glaucoma cases. Some common MIGS procedures include:You have cataracts or need lens replacement for refractive purposes.

  • iStent: The iStent is the smallest medical device implanted in the human body. It is a one millimetre tube made of titanium, and is inserted into the natural drainage channel of the eye. It enhances natural drainage pathways within the eye to lower IOP. Normally, two or three devices are implanted.

  • GATT (Gonioscopy Assisted Transluminal Trabeculotomy): This procedure uses a a device that removes a portion of the eye's drainage tissue, creating a new outflow pathway for aqueous humor.

  • Elios (Excimer Laser Trabeculostomy): This is a device that creats precise openings in the drainage tissue of the eye to facilitate fluid outflow

  • Preserflo Microshunt: This is a tiny gel-like tube implanted into the eye to facilitate fluid drainage. It becomes a bypass, so the excess fluid drains to a small blister under the surface of the eye.

  • MiniJect: This device is inserted into an area in the eye that connects the fluid of the eye to the space beneath the sclera to facilitate drainage of fluid outflow.

  • Kahook Dual Blade: This device allows thesurgeon to create a controlled opening in the drainage tissue, improving aqueous humor drainage.


Is MIGS Right for Me?

Your consultant will evaluate your individual case and determine if MIGS is a suitable option. MIGS is often recommended for individuals with mild to moderate glaucoma and those looking to reduce their reliance on glaucoma medications. It is often combined with cataract removal.


How does Minimally Invasive Glaucoma Surgery Work?

MIGS is typically performed under local anesthesia and as an outpatient procedure. Your surgeon will discuss the specific MIGS technique recommended for you. During the procedure, you can expect:


  • Small incisions or micro-insertions.

  • A quick recovery period.

  • Post-operative care instructions, including the use of prescribed eye drops and follow-up appointments.


What is the recovery time for minimally invasive glaucoma surgery?

Recovery from the surgery typically takes about one to two weeks. You'll likely need to use antibiotic or steroid eye drops for several weeks or months to aid recovery. Attending follow-up appointments is essential to ensure the treatment is effective, reducing eye pressure, and checking that your eye is healing well. However, the number of follow-up visits is usually fewer than for procedures like trabeculectomy.


What are the side effects of minimally invasive glaucoma surgery?

While MIGS procedures are generally safe and well-tolerated, there are potential risks, including:


  • Infection or inflammation.

  • Increased or decreased IOP.

  • Blood clot formation.

  • Corneal damage.


Your surgeon will discuss these risks with you before the procedure.


Conclusion:

Minimally Invasive Glaucoma Surgery (MIGS) represents an exciting advancement in glaucoma management. If you and your consultant decide that MIGS is appropriate for your condition, you can look forward to a less invasive procedure with the potential for reduced medication use and improved pressure control.


Minimally Invasive Glaucome Surgery at Eyepros

We offer a free no-obligation consultation to discuss your needs and what options would be most suitable for you. We have treatment centres based around the Midlands, including Nottingham, Birmingham and Derby. Get in touch to book your consultation.



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About The Author

Mr Ahmad Elsahn
ABOUT

Mr Ahmad Elsahn

Mr Ahmad Elsahn is a highly accomplished Consultant Ophthalmologist specialising in cataract surgery, minimally invasive glaucoma surgery and laser eye surgery, with over two decades of experience.

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