MInimally invasive glaucoma surgery

High pressure in the eye is the main risk factor for glaucoma. Minimally Invasive Glaucoma Surgery (MIGS) is a group of procedures and devices which aim to reduce and normalise the eye pressure. Additionally, as the use of eye drops for treating glaucoma can cause long term side effects and discomfort, MIGS can help to reduce the number of eye drops required to control the pressure and therefore, improve the quality of life. 

  MIGS allow for improvement of the outflow mechanisms of the eye avoiding major alterations in normal ocular anatomy. Different types of MIGS have different ways of reducing the eye pressure, but what they have in common is a quicker recovery compared to standard glaucoma surgery (trabeculectomy and “tubes”), with minimal additional downtime for patients.

MIGS device can reduce the eye pressure in two ways 

1) Ab-externo: by creating an “alternative pathway” for the fluid in excess to be drained into a small blister (called a bleb) under the conjunctiva (the surface of the eye) and under the upper eyelid. 

2) Ab-interno:  by improving the outflow of the natural drainage canal of the eye. This can be achieved with stents (for example, iStents® and Hydrus®) or by expanding the drainage system with a gel (viscoelastic) that is then naturally reabsorbed (OMNI®)

Most MIGS take approximately 20-30 min and they are performed under local anaesthesia in the operating theatre. The postoperative period involves a few weeks course of antibiotic and anti-inflammatory eye drops. The eyesight might be slightly blurred during the days immediately after surgery. If glaucoma drops are used before surgery it is generally recommended to continue the same drops until the follow up visit with your surgeon, who might consider reducing them gradually over the following weeks

More information about MIGS can be found in the procedures’ information section