A healthy eye’s natural fluid (aqueous humor) is produced and drained through a circular canal at the front of the eye, called Schlemm’s canal. Glaucoma interrupts the ebb and flow of fluid by blocking the entrance to that drainage system, leading to increased eye pressure that damages the eye’s nerve tissue and causes vision impairment. Minimally invasive glaucoma surgery (MIGS) offers new treatment options for people with mild to moderate glaucoma.
MIGS vs. Traditional Glaucoma Treatments
Glaucoma treatments are designed to reduce fluid produced in the eye or increase drainage through medications, laser treatments or surgery. Traditional glaucoma surgeries can be quite effective but come with significant risks, including eye infection, cornea swelling, too-low eye pressure and double vision. Most eye surgeons delay surgery for those reasons until less invasive treatments have been exhausted.
MIGS offers some of the benefits of traditional surgery with fewer risks. When MIGS is combined with selective laser trabeculoplasty, it can eliminate the need for glaucoma medications. The surgeons at Atlanta Vision Cataract & Laser Center will discuss your glaucoma treatment options during your appointment at our Atlanta office.
Types of MIGS
Before fluid can enter Schlemm’s canal (that circular tube in the front of the eye), it must go through the trabecular meshwork, a sponge-like tissue found by your cornea. In glaucoma patients, this meshwork is clogged and creates a dangerous buildup of pressure in the eye. MIGS procedures address these ocular areas in different ways.
One form of MIGS enhances fluid outflow by removing a section of the trabecular meshwork or opening it completely to restore proper drainage and relieve eye pressure. Another type dilates the canal and its downstream channels to increase drainage. Other MIGS variations involve directing fluid output outside of the eye using a shunt or lowering fluid production within the eye. A small mesh implant may be used to reinforce the drainage pathway and hold it open in some cases.
MIGS doesn’t replace the need for traditional glaucoma surgery. Still, this option provides earlier surgical intervention for glaucoma patients who would otherwise have to wait until their symptoms worsened to qualify for conventional glaucoma surgery. MIGS can effectively lower intraocular pressure with fewer risks and offers a faster recovery in patients with mild to moderate glaucoma.
MIGS and Cataract Surgery – Two Procedures, One Incision
Glaucoma and cataracts are two of the leading causes of vision loss and blindness worldwide. These eye diseases often coexist and worsen with age. The new technologies used in MIGS allow our eye surgeons to treat glaucoma and remove cataracts at one time. Combining glaucoma and cataract surgery can provide a sustained decrease in eye pressure while removing the clouded natural eye lens and replacing it with an intraocular lens implant (IOL). This combination of procedures may be best for those with mild to moderate glaucoma who have significant vision impairment from a cataract.
MIGS Benefits
MIGS provides a surgical option for glaucoma patients who don’t have vision loss severe enough to warrant trabeculectomy surgery but don’t see much improvement with medicated eye drops. There are fewer complications and a lower risk of infection, but MIGS is not as effective as the traditional procedure. However, MIGS is highly effective at lowering eye pressure, reducing complications and opening glaucoma surgery as an option to a broader pool of patients.
MIGS recovery is faster than traditional glaucoma surgery because it is less invasive, and post-operative vision is better.
Minimally Invasive Glaucoma Surgery (MIGS) FAQs
What is minimally invasive glaucoma surgery (MIGS)?
MIGS is a group of surgical procedures designed to lower intraocular pressure in patients with mild to moderate glaucoma. These procedures improve the eye’s natural drainage system or reduce fluid production using much smaller incisions than traditional glaucoma surgery, resulting in fewer risks and faster recovery.
How does MIGS differ from traditional glaucoma surgery?
Traditional glaucoma surgery is effective but carries higher risks, such as infection, corneal swelling, very low eye pressure, and double vision. MIGS offers pressure reduction with fewer complications and is often considered earlier in the disease process when medications or laser treatments are not sufficient.
What types of MIGS procedures are available?
There are several types of MIGS procedures. Some remove or open part of the trabecular meshwork to improve fluid drainage, others dilate Schlemm’s canal, and some use tiny shunts or mesh implants to redirect fluid and maintain open drainage pathways. Your surgeon will recommend an option based on your eye anatomy and glaucoma severity.
Can MIGS be combined with cataract surgery?
Yes. MIGS can often be performed at the same time as cataract surgery using the same incision. This approach allows surgeons to treat glaucoma and remove cataracts simultaneously, helping to lower eye pressure while restoring clearer vision.
Who is a good candidate for MIGS?
MIGS is typically recommended for patients with mild to moderate glaucoma who are not adequately controlled with eye drops alone but do not yet require traditional glaucoma surgery. A comprehensive eye exam is needed to determine candidacy.
What are the benefits and recovery expectations with MIGS?
MIGS offers a faster recovery and fewer complications compared to traditional glaucoma surgery. Many patients experience improved post-operative vision and reduced reliance on glaucoma medications, although MIGS may not lower eye pressure as much as more invasive procedures.
Schedule Your Eye Exam at Atlanta Vision Cataract & Laser Center
If you’re interested in learning more about MIGS and your glaucoma treatment options, contact Atlanta Vision Cataract & Laser Center today to schedule an appointment.