Minimally-Invasive Glaucoma Surgery (MIGS)
At New Eyes Las Vegas, our experienced eye doctors are proficient in several advanced treatments for glaucoma. Over 3 million Americans suffer from this condition, which has long remained the leading cause of preventable blindness*. While it is not curable, glaucoma can be very treatable in the hands of an ocular health professional – especially when the issue is detected sooner rather than later.
Among the most popular procedures to manage glaucoma symptoms is a category of treatments known as minimally-invasive glaucoma surgery (frequently shortened to “MIGS”). Often reserved for patients who have not responded to prescription eye drops or laser surgery with selective laser trabeculoplasty (SLT), MIGS procedures can ease the severity of glaucoma while minimizing trauma and promoting faster recovery compared to traditional glaucoma surgeries.
- What Is Minimally-Invasive Glaucoma Surgery (MIGS)?
- MIGS Benefits
- MIGS Candidates
- MIGS Procedure
- MIGS Recovery
- MIGS Cost
- MIGS FAQ
What Is Minimally-Invasive Glaucoma Surgery (MIGS)?
MIGS refers to minimally-invasive surgeries which aim to lower intraocular pressure (IOP) by enhancing the drainage of aqueous humor from the eye. Aqueous humor can help provide nutrients and maintain the shape of the eye, but in glaucoma patients, there may be an imbalance in the production and drainage of aqueous humor, leading to increased IOP. Depending on the specific technique being used, the procedures may employ microscopic incisions, implants, or devices to increase the outflow of fluid.
While MIGS can help preserve the remaining vision and prevent further damage to the optic nerve, its primary goal is the management of glaucoma rather than a cure, which has yet to be developed. In other words, although they cannot completely eliminate glaucoma, MIGS procedures can help maintain functional vision and quality of life for individuals with glaucoma.
What Are the Benefits of MIGS?
The innovative procedures available for minimally-invasive glaucoma surgery offer many benefits†, including:
- Reduction and long-term control of eye pressure
- Suitability for mild to moderate glaucoma
- Minimal trauma to delicate eye tissue
- Fewer risks compared to traditional glaucoma surgery
- Relatively quick recovery time
As an additional benefit, MIGS procedures may be combined with cataract surgery. Performed together, the surgeries can potentially ease symptoms of both conditions and reduce the need for intensive measures (i.e. medications or more invasive surgeries).
† Individual Results May Vary
Who Is a Candidate for MIGS?
Candidates for minimally-invasive glaucoma surgery may include patients with mild to moderate glaucoma who have not achieved adequate control of their (IOP) with medications or SLT. Patients seeking MIGS often also want to reduce their dependence on glaucoma medications. Alternatively, they may be unable or uninterested in using the prescription eye drops that are typically offered as a first step in treating glaucoma. Moreover, the specific criteria for MIGS candidacy can vary depending on the surgeon and the type of MIGS procedure being considered.
How Is MIGS Performed?
At New Eyes, we offer the following types of minimally-invasive glaucoma surgery:
ABiC™ (Ab-Interno Canaloplasty, Using the iTrack Catheter)
The iTrack ABiC™ procedure utilizes a tiny micro-catheter to enlarge the drainage canal of the eye without cutting through the outer wall of the eye. Not to be mistaken with traditional canaloplasty, this minimally-invasive approach leaves no hardware or other glaucoma devices behind.
GATT (Gonioscopy-Assisted Transluminal Trabeculotomy)
In the GATT procedure, the drainage system is unroofed in a minimally-invasive fashion, allowing greater access to the drain of the eye.
iStent® Trabecular Micro-Bypass Stent
The iStent® is part of a dual procedure to treat glaucoma and cataracts. Following cataract surgery, a tiny stent – the smallest medical device approved by the FDA – is placed in the eye to enhance drainage.
MIGS procedures are usually performed under local anesthesia, meaning the eye is numbed with eye drops or injection. Some MIGS procedures may also require sedation. Your surgeon will use specialized microscopic instruments to access the anterior chamber of your eye, where the fluid (aqueous humor) is located. After the MIGS device or implant is properly positioned, your surgeon will ensure that the incisions are properly closed. Some incisions may be self-sealing and do not require sutures.
What Does Recovery From MIGS Entail?
Recovery from MIGS is generally quicker and less complicated compared to traditional glaucoma surgeries, though this may vary depending on the methods utilized. Immediately following your surgery, we will monitor your progress for a short time, and your eye may be patched or shielded for a period*. We may prescribe eye drops or other medications to help prevent infection, reduce inflammation, and control IOP. In the weeks afterward, it is critical that you attend your scheduled follow-up appointments so our doctors can ensure you are healing properly.
How Much Does MIGS Cost?
Because MIGS procedures are personalized, pricing for these surgeries can vary considerably. Fortunately, glaucoma treatment is often covered by health insurance plans, though this can also depend on the plan and the severity of the condition.
Our team at New Eyes works with a number of plans and is happy to communicate with your insurance as needed. Additionally, certain patients may be eligible to finance their care with CareCredit®, a reputable third-party financier with whom New Eyes proudly partners. Please do not hesitate to direct any financial questions to our staff.
Additional MIGS FAQs
Is MIGS painful?
MIGS procedures generally involve the use of local anesthesia or other types of sedation; as such, the surgery itself is not typically considered painful. Provided you adhere to your aftercare instructions, use eye drops as directed, and attend your follow-up appointments, you should not experience significant discomfort. With this in mind, we always welcome you to come to us with any concerns or questions.
Is MIGS safe?
When performed by an experienced ocular care professional, MIGS is typically both very safe and highly successful. Further, one of MIGS’ most common advantages is its tendency to minimize (in fact, often entirely mitigate) the trauma and complications associated with more intensive procedures.
What risks are associated with MIGS?
As mentioned above, MIGS is known to produce significantly fewer side effects than traditional glaucoma surgeries. That said, you may notice swelling, redness, and irritation following the procedure, but these are usually mild and not cause for alarm.
How long does it take to recover from MIGS?
In addition to the lower risk profile, the potential for a quicker post-operative recovery makes MIGS an attractive choice for many patients and practitioners. While your recovery time may vary based on techniques used and specifics of your condition, you can expect your recovery period to last about two weeks at the most.
Is MIGS covered by insurance?
MIGS is frequently covered by insurance; however, as this is not the case for every plan, we feel that it is always worthwhile to make sure. Our friendly office staff is happy to communicate with your insurance as necessary and help you navigate your benefits. Feel free to reach out to us with any questions.
To schedule an appointment with one of our renowned eye doctors or learn more about MIGS procedures, please contact New Eyes today.
Medical References*
National Library of Medicine
American Academy of Ophthalmology
Johns Hopkins Medicine