MIGS (Minimally Invasive Glaucoma Surgery) is a newer pool of procedures aimed at increasing surgical safety and offering a less invasive treatment option for patients who fall into the mild to a moderate category of glaucoma.
For many patients, medications and laser therapy work great at controlling eye pressure, but for some, additional, more drastic treatments may be necessary. The gap from medications and laser procedures to the next level of treatment options, like filtration and shunt surgery, is a big leap, and although these procedures offer a greater reduction in eye pressure, they also carry an increased risk.
MIGS populate the space between eye medications and laser treatments and the jump to the more advanced procedures. MIGS uses microdevices and surgical instruments, providing a moderate reduction in eye pressure with minimal post-surgical risks.
There are a number of medical devices and techniques we can use to bypass the trabecular meshwork (or the blockage), creating a new pathway for fluid to drain. In some instances, this new pathway is created through the implantation of a device, like the iStent or Hydrus. We offer a different set of procedures that achieve a similar result; however, it’s accomplished through surgical incision/excision of the eye’s inner tissue.
Minimally Invasive Glaucoma Surgeries utilizing the placement of a device or stent are common and effective treatment options for many patients. The iStent and Hydrus are common bypass devices, and oftentimes are implanted along with cataract surgery to help improve vision and reduce eye pressure at the same time. (This may also help with insurance eligibility.) These devices are delicately implanted within just a few minutes and will immediately begin working to safely and effectively manage eye pressure.
Similar to the bypass devices above, this set of procedures creates an opening through the blockage to improve the eye’s natural outflow of aqueous humor (the fluid within the eye), however it’s done without implanting an actual device. These procedures can be performed alone or combined with cataract surgery. Common bypass procedures performed at Minnesota Eye Consultants include a Canaloplasty and Goniotomy.
The XEN Glaucoma implant is in a category of its own, as it’s the only FDA-approved device used for the subconjunctival space in the eye. This tiny surgical implant (about the length of an eyelash) is placed under the clear membrane that covers the eye (called the conjunctiva). The goal of this device is to lower eye pressure in open-angle glaucoma patients.
One of the common bypass devices used at Minnesota Eye Consultants is the iStent. As the world’s tiniest medical device, the iStent is 20,000 times smaller than the intraocular lenses (IOL) used in your cataract surgery. The iStent works similarly to the stents used to prevent heart attacks and strokes. When blood vessels become clogged, a stent creates access to the vessel flow. While a highly innovative technology, how iStent works is elegantly simple:
The iStent can be delicately implanted during your cataract surgery, and shockingly, it just takes a couple of minutes. Once implanted in the drainage canal, the iStent will begin working to safely and effectively manage your eye pressure.
Following your procedure, you may have the opportunity to reduce some of your medications, but of course, your physician will discuss whether or not this is right for you.
Here are a few fun facts about the iStent device:
Minnesota Eye Consultants is proud to offer patients convenient access to eye care across the Twin Cities. We have 4 locations, each with an onsite ambulatory surgery center (ASC).