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Minimally Invasive Glaucoma Surgery (MIGS)

Minimally Invasive Glaucoma Surgery (MIGS)

MIGS refers to a group of newer glaucoma surgeries designed to lower intraocular pressure (IOP) with less trauma to the eye compared to traditional surgeries like trabeculectomy. MIGS procedures are typically minimally invasive, safer, faster recovery, and have very few complications. MIGS can often be combined with cataract surgery in the same sitting or can be done as a stand-alone procedure.

These procedures aim to slow glaucoma progression by lowering IOP — they cannot restore lost vision. MIGS is most suitable for patients with early to moderate glaucoma, especially those who are allergic to topical anti-glaucoma medications or unable to self-administer eye drops.

MIGS can reduce the need for glaucoma drops but may not eliminate them. Lifelong monitoring is still necessary even if IOP is controlled after surgery. MIGS procedures have a success rate of 60–80% in achieving significant IOP reduction, especially when combined with cataract surgery.

While the pressure-lowering effect is generally less dramatic than traditional trabeculectomy, the safety profile and faster recovery make MIGS a valuable option for many patients. Complications can still occur, including Bleeding in the eye (hyphema), transient eye pressure spikes, malposition or blockage of the stent, failure of the device leading to inadequate pressure control & rarely, infection or persistent inflammation.

frequently asked questions

  • Patients should undergo a comprehensive eye examination to determine the type and severity of glaucoma.
  • Blood pressure and blood sugar should be well controlled.
  • Routine blood tests or other investigations may be done if needed.
  • Patient has to take their regular medications & come to surgery.
  • Patients will be counselled about the procedure, expected outcomes, and the need for ongoing glaucoma management.
  • MIGS procedures are usually done under local anaesthesia.
  • The surgery typically takes 15–30 minutes.
  • Through a tiny corneal incision, the surgeon inserts specialized devices or uses micro-instruments to improve aqueous outflow by targeting trabecular outflow.
  • The eye will be patched after the surgery and sent home the same day.
  • Patients may experience mild discomfort, redness, or blurry vision for a few days. This is normal.
  • Patients are advised to use eye drops (antibiotics and steroids) as prescribed by doctor to prevent infection and reduce inflammation.
  • Activity restrictions such as avoiding eye rubbing, heavy lifting, or bending over are advised for at least a week.
  • Vision usually stabilizes faster compared to traditional glaucoma surgeries.
  • Early follow-up is crucial to detect and manage complications such as IOP spikes or stent obstruction.
  • Frequent check-ups in the first few weeks after surgery to monitor eye pressure and healing.
  • Regular visits every few months, depending on the stability of glaucoma and the doctor’s advice, are recommended.