Minimally Invasive Glaucoma Surgery
New techniques and implants are being developed to find alternative surgical means to control IOP with fewer potential side effects and faster recovery. These are collectively called MIGS: minimally invasive glaucoma surgery. Most MIGS operations are designed to allow extra fluid to leave the eye and hence lower the IOP.
MIGS and its potential benefits for glaucoma patients.
• The Preserflo Micro Shunt. An ab-externo drainage system that helps reduce IOP. According to recent results, it is as effective as trabeculectomy in lowering IOP in moderate to advanced glaucoma and is reported to be less invasive with patients requiring less follow-up or postoperative interventions. www.glaukos.com
The iStent® inject implant is a tiny device (less than 1mm) that is inserted through the trabecular meshwork into Schlemm’s canal, usually at the time of cataract surgery, to aid fluid outflow. Previous variants had a different shape, like a periscope that is inserted sideways. www.glaukos.com
• The XEN® gel implant, on the other hand, drains fluid from the anterior chamber into the conventional surgical drainage space, the subconjunctival tissue. www.xengelstent.com
• The Hydrus® is an implant that holds the canal open and helps outflow of fluid (find out more, go to www.ivantisinc.com)
• Canaloplasty ‘tents’ the canal open by feeding in and then tying off a fine circumferential thread within the canal.
Many MIGS procedures can be combined with cataract surgery, and we advise you to discuss these options with your specialist.
MIGS procedures may be particularly beneficial in:
1. People intolerant to eye drops because of side-effects or allergy
2. People unable to use eye drops for other health reasons
3. People having a cataract operation who has mild to moderate glaucoma who would like to decrease the number of drops they are using.