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What are MIGS Procedures?

Ophthalmologists, particularly glaucoma specialists, provide MIGS as part of a number of treatment options available to their patients.

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Close-up photograph of an eye
Close-up photograph of an eye

What are MIGS Procedures?

Ophthalmologists, particularly glaucoma specialists, provide MIGS as part of a number of treatment options available to their patients.

What does MIGS stand for?

MIGS stands for Minimally Invasive Glaucoma Surgery.

 

What are the various types of MIGS available?

MIGS procedures are categorized based on how they lower eye pressure.

  • Angle-based MIGS enhance fluid outflow through the eye’s natural drainage angle by stenting the Schlemm’s canal (e.g., iStent W, iStent Infinite, Hydrus microstent), removing the trabecular meshwork (e.g., Kahook dual blade goniotomy, GATT, Trabectome), expanding the Schlemm’s canal with viscous gel (Streamline), or combining these approaches (OMNI surgical system).
  • Subconjunctival MIGS devices (e.g., XEN gel stent) create a new drainage pathway to the external surface of the eye.
  • Cyclophotocoagulation with an endolaser or micropulse laser reduces eye pressure by reducing the amount of fluid that the eye makes.

 

Who is a good candidate for MIGS procedures?

For angle-based MIGS, the best candidates are those with mild to moderate primary open-angle glaucoma (POAG). Other candidates include those who have side effects to medical therapy, or those who have undergone other procedures and still have elevated eye pressures.

 

Who performs these procedures?

Ophthalmologists, particularly glaucoma specialists, provide MIGS as part of a number of treatment options available to their patients.

 

How do MIGS procedures compare with traditional glaucoma surgery?

When compared to traditional glaucoma surgeries such as trabeculectomy and aqueous drainage devices, MIGS procedures have lower efficacy but an improved safety profile. For most patients with mild to moderate glaucoma, the MIGS procedures provide adequate IOP lowering while reducing the risk of the potentially severe complications associated with traditional glaucoma surgeries.

 

Article by Regine Pappas, MD; posted on August 15, 2023.

 

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Regine Pappas, MD

Dr. Regine Pappas is a Board-certified ophthalmologist, eye surgeon, and Fellowship-trained glaucoma specialist at Pinnacle Eye Center in Melbourne, Florida.