Minimally Invasive Glaucoma Surgery (MIGS)
Who Benefits from MIGS?
MIGS is designed for people whose eye pressure remains high despite eye drops or laser treatment and for those who wish to lessen their reliance on medications.
Patients with primary open-angle glaucoma who need a moderate drop in pressure often benefit most. MIGS also helps individuals who cannot tolerate long-term drops or struggle with daily dosing.
When performed during cataract surgery, MIGS can use the same incision, giving patients two solutions in a single visit and an easier recovery.
For advanced glaucoma that requires very low pressure, standard incisional surgery may still be advised. Your eye doctor will recommend the approach that best protects your optic nerve.
Risks Associated with MIGS
Although MIGS is safer than older glaucoma surgeries, every procedure carries some risk.
Patients may notice mild bleeding inside the eye, temporary pressure spikes, or short-lived inflammation after surgery.
Serious problems such as infection or persistent low pressure are uncommon but possible. Your surgeon will discuss these concerns before the operation.
How MIGS Works
MIGS lowers eye pressure by improving how aqueous humor leaves the eye or by reducing how much fluid the eye makes. Different techniques target specific parts of the drainage system.
These tiny stents create a direct path from the eye’s fluid chamber into Schlemm’s canal.
- iStent and iStent Inject help many patients achieve about a 20 percent pressure drop.
- Hydrus Microstent holds Schlemm’s canal open to improve drainage.
Small sections of the meshwork are removed to widen the natural outflow channel.
- Kahook Dual Blade excises tissue with a dual-edge blade.
- Trabectome uses gentle electrocautery to clear a strip of tissue.
- GATT opens the full 360-degree canal using a microcatheter or suture.
These methods expand Schlemm’s canal to boost outflow without removing tissue.
- VISCO360 or OMNI combines canal dilation with a limited trabeculotomy.
- Ab Interno Canaloplasty, known as ABiC, threads a microcatheter through the canal and injects viscoelastic material as it is withdrawn.
Certain shunts direct fluid to spaces outside the traditional pathway.
- XEN Gel Stent moves fluid to the subconjunctival space and helps in refractory cases.
- Research continues on safe suprachoroidal devices for future use.
Instead of improving drainage, some procedures lower production of aqueous humor.
- Endocyclophotocoagulation, or ECP, uses a laser to treat the ciliary body and slow fluid creation.
What to Expect Before, During, and After Surgery
Knowing each step of the process helps patients feel confident and prepared.
Your eye is numbed with local anesthesia, and the surgeon uses very small cuts to place the device or perform the technique. MIGS is usually an outpatient surgery, so you return home the same day.
Most people notice mild discomfort or blurry vision for a short period. Prescription drops reduce inflammation and prevent infection, and follow-up visits allow your doctor to track healing. Avoid heavy lifting and protect your eyes until cleared for normal activities.
Benefits and Considerations of MIGS
MIGS offers many advantages, yet ongoing care remains essential because glaucoma is a lifelong condition.
Patients often choose MIGS for its blend of safety and convenience.
- Less invasive surgery with smaller incisions
- Faster recovery and quicker return to daily tasks
- Reduced dependence on glaucoma medications
- Fewer complications than traditional surgery
- Can be performed during cataract surgery for added efficiency
MIGS slows glaucoma but does not cure it. Lifelong monitoring ensures eye pressure stays within a safe range, and additional treatments can be added if pressure rises again.
Frequently Asked Questions
The following answers address common concerns our patients share about MIGS.
No. MIGS involves micro-devices or small surgical techniques, while laser procedures such as selective laser trabeculoplasty use laser energy to improve outflow without implants.
MIGS lowers eye pressure and slows disease progression, but glaucoma remains a chronic condition that requires regular follow-up care.
Results vary by individual. Many patients enjoy lower pressure for several years or longer, yet periodic checkups are needed because glaucoma can change over time.
Your doctor will monitor pressure, adjust medications if needed, and schedule routine exams. Some patients continue drops at reduced doses, while others may stop drops entirely.
Partner with Our Eye Care Team
Protecting your vision is our priority. Our experienced eye doctors in Woodland Park and Edison use the latest MIGS techniques to manage glaucoma while supporting your long-term eye health. We look forward to guiding you through a personalized treatment plan that fits your needs and lifestyle.
Dr. Arnett is very kind
Shirly
Excellent care Dr.Jai & group. Wonderful Staff compassion care, polite, always helpful, & clean I have been a patient for many many years & I wouldn't go anywhere else.The Best Care!!!
tina xxxx
Dr. Jai Parekh is a shining example of professionalism and excellence. And we love how friendly the doctors and staff are! They feel like family!
michael succardi
Dr. Kayserman was gentle, efficient and provided extremely valuable information which was comforting to me. I felt better after seeing her and am looking forward to additional visits.
Lina N.
All the doctors I have seen at this practice genuinely care about my eyecare needs and they always listen to my concerns: that’s not easy to find in the medical field.
Shaun Mehtani