Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
Minimally invasive glaucoma surgery (MIGS) refers to a group of newer surgical techniques that lower eye pressure through very small incisions, using tiny devices or instruments to improve the eye's natural drainage system. Compared with traditional glaucoma surgeries like trabeculectomy or tube shunts, MIGS procedures are generally designed to be gentler on eye tissue and involve a faster recovery, though they typically lower eye pressure less dramatically. Many MIGS procedures are performed at the same time as cataract surgery, since both share a small corneal incision. MIGS is a rapidly evolving field with several different device types and techniques, each working through a slightly different mechanism to improve fluid outflow.
Who typically needs this
- Most often considered for mild to moderate open-angle glaucoma, particularly in patients who are also having cataract surgery.
- An option for patients who want to reduce their reliance on daily glaucoma eye drops.
- Considered for patients whose glaucoma needs more pressure lowering than medication alone provides, but who are not yet candidates for more invasive surgery like trabeculectomy.
- Generally not intended for advanced glaucoma requiring very low target pressures, where traditional filtration surgery may be more appropriate.
What to expect
- Performed under local anesthesia, often combined with cataract surgery in the same operating session.
- A very small incision, similar in size to a cataract surgery incision, is used to access the front chamber of the eye.
- Depending on the specific MIGS technique, the surgeon may implant a tiny stent or shunt, remove a strip of the trabecular meshwork, or create a micro-channel to improve fluid outflow.
- Because the incisions are small and tissue disruption limited, the procedure typically adds only a short amount of time to cataract surgery, or can be done alone in a similarly brief operation.
Recovery
- Recovery is generally faster and more comfortable than after traditional glaucoma surgery, with many patients resuming normal activities within a few days.
- Standard post-surgery drops, antibiotic and anti-inflammatory, are used for a few weeks.
- Vision typically stabilizes over one to a few weeks, similar to recovery after cataract surgery alone.
- Follow-up visits are needed to monitor eye pressure, since the full effect can take some weeks to become clear.
Risks to know about
- Eye pressure may not be lowered as much as with traditional glaucoma surgery, and some patients still need drops afterward.
- A temporary rise in eye pressure, mild inflammation, or blurred vision can occur in the early recovery period.
- Some MIGS devices can shift position, become blocked, or require removal or additional surgery.
- As with any eye surgery, there is a small risk of bleeding, infection, or reduced vision.
Frequently asked questions
Will MIGS replace my need for cataract surgery, or vice versa?
MIGS is frequently combined with cataract surgery in the same procedure when both are needed, but each can also be done on its own.
Is MIGS a permanent fix for glaucoma?
MIGS lowers eye pressure but does not cure glaucoma. Ongoing monitoring, and sometimes continued medication, is still usually needed.
How is MIGS different from trabeculectomy or tube shunt surgery?
MIGS uses smaller incisions and generally has a gentler recovery, but it usually lowers eye pressure less than trabeculectomy or tube shunt surgery, making it best suited for milder glaucoma.
Will my ophthalmologist recommend a specific MIGS device?
Yes. Several different MIGS techniques and devices exist, and the surgeon chooses the one best suited to the anatomy and severity of your glaucoma.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: Glaucoma Research Foundation — What Is MIGS?, AAO — Combined Cataract-Glaucoma Surgery and MIGS . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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