Micro/Minimally Invasive Glaucoma Surgery (MIGS)

Micro/Minimally Invasive Glaucoma Surgery (MIGS)

Micro/Minimally Invasive Glaucoma Surgery (MIGS)

Micro/Minimally Invasive Glaucoma Surgery (MIGS)

Glaucoma is a disease that damages the optic nerve in your eye. Your eyes constantly produce a fluid (aqueous humor) to support the structures within the eye. In the case of a healthy eye, the fluid drains out properly and produces a stable pressure (intraocular pressure). If the drainage becomes clogged, the fluid builds up, which increases pressure inside the eye. The increased pressure damages the optic nerve, which then affects vision, particularly your side or peripheral vision.  


The two most common types of glaucoma are: primary open angle glaucoma and angle-closure glaucoma.  


Primary Open Angle Glaucoma 

  • Most common type 

  • Slow clogging of fluid drainage in the eye 

  • Painless 

  • Can be detected early through regular eye exams 


Angle-Closure Glaucoma 

  • Occurs when the iris is in close proximity to the eye’s drainage angle, thereby blocking fluid drainage 

  • Can cause “acute attacks” when the drainage angle is blocked completely 

  • Acute attack symptoms 

  • Sudden onset of blurry vision 

  • Presence of halos or rainbow rings, especially around lights 

  • Headache 

  • Nausea or vomiting 

  • Severe eye pain 

  • Can cause blindness when left untreated  



If you have glaucoma, the most important goal is to decrease the intraocular pressure (IOP). There are several major surgeries that can help lower IOP, but like any surgery, there are risks and potential complications. To learn more about these surgeries, check out our blog post on Treating Glaucoma with Laser Surgery


The field of glaucoma management has evolved in recent years. Interventional glaucoma uses a proactive approach to prevent significant vision loss well before it is a factor. Micro or minimally invasive glaucoma surgery (MIGS) has allowed ophthalmologists to intervene much sooner given the high safety profile of the options. In addition, MIGS still allows for future major glaucoma surgeries to be performed. It has the potential to replace medications as the first step of therapy. 

MIGS are a group of procedures that reduce IOP and/or medication burden (and associated compliance issues) with a level of safety that exceeds that of older, more aggressive glaucoma procedures. There are several types of MIGS that use state-of-the-art microscopic instruments to facilitate small incision surgery with high success rates and faster recovery times compared to conventional glaucoma surgeries.  

To learn more about MIGS and the different options offered at Coastal Vision Medical, visit our website.  

MIGS procedures constitute a group of surgical interventions which share five characteristics:  

  1. High safety profile: MIGS carry a much lower risk of serious complications such as hypotony, choroidal effusions, or choroidal hemorrhages.  

  1. Minimal disruption of normal anatomy: MIGS allow for enhancement of physiological outflow mechanisms avoiding major alterations in normal ocular anatomy. 

  1. Ab interno approach: MIGS are typically performed ab interno through a traditional clear corneal wound with direct visualization of the anatomical target.  

  1. Efficacy: MIGS should offer meaningful IOP lowering effect. The level of IOP reduction is often inferior to traditional filtering surgery but should be at least 20%.  Alternatively, patients who do not experience an IOP decrease should attain the reduction of at least one medication. 

  1. Ease of use for patients and physicians: MIGS should allow for a rapid recovery with minimal additional downtime for patients.  They should also be easily incorporated into traditional phacoemulsification surgery. 


American Academy of Ophthalmology Eye Wiki: MIGS 

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