Many think of glaucoma as a simple problem: Increased pressure in the eye damages the optic nerve, leading to irreversible vision loss and potential blindness. Yet it’s a complex group of diseases. Consequently, we need a wide range of treatment options. Relatively new procedures known as MIGS are less invasive surgeries, providing alternatives to patients with fewer risks than more traditional glaucoma surgeries.
The letters stand for Minimally Invasive or Micro-invasive Glaucoma Surgeries. A doctor performs these procedures through small, clear corneal incisions, similar to cataract surgery. They can be safer, less invasive, and involve less recovery time in comparison to more traditional surgeries. The decision on which surgical intervention may work best is based on a thorough examination by your doctor. Considerations including intraocular pressure, severity of disease, and other contributing factors. (You will find information on Horizon Eye Care’s Glaucoma services page.)
Procedures to Consider
Although there are various surgical approaches, here we will highlight three:
- Micro-trabecular bypass: The trabecular meshwork (TM) is the point of greatest resistance to fluid outflow in the anterior chamber angle of the eye. Procedures to bypass this system include the iStent (Glaukos) and the Hydrus microstent (Alcon).
- Trabecular meshwork bypass by removal of TM and/or enhancement of outflow through the canal behind the TM (Schlemm’s canal). These procedures include the Kahook dual blade (New World Medical) and the OMNI Surgical System (Sight Sciences).
- Reducing fluid production: Internal laser procedures such as endoscopic cyclophotocoagulation (BVI) reduce the production of aqueous humor using a laser and light source.
Pros and Cons of MIGS
As with any surgical procedure, there are pros and cons of MIGS. On one hand, patients can expect less risk and faster recovery time with fewer restrictions on activities. A surgeon can perform MIGS as a stand-alone procedure or, in some cases, in conjunction with cataract surgery. In cases where significant, sustained reduction of intraocular pressure is needed, your doctor may recommend a more traditional glaucoma surgery such as trabeculectomy or implantation of a glaucoma drainage device. Your doctor can provide you with a risk-benefit analysis of your options.
Any damage to the optic nerve and vision is irreversible, and all treatment options are aimed at slowing the disease process. No matter what treatment option your doctor recommends, in most cases glaucoma is a life-long disease that requires frequent surveillance and potential additional treatment.
Glaucoma is often a silent process, stealing vision without pain or other symptoms. An annual in-person eye exam is crucial for early detection and timely treatment. Thankfully, we now have many different treatment options that can be tailored to each individual patient.
To schedule an exam at Horizon Eye Care, call 704-365-0555 Monday – Thursday, 8:00 a.m. to 5:00 p.m. and Friday 8:00 a.m. to 3:00 p.m.