What is minimally invasive glaucoma surgery (MIGS)?

MIGS is an abbreviation which stands for minimally invasive glaucoma surgery. MIGS refers to a range of different implants, techniques and devices which are used by a Consultant Ophthalmologist to treat glaucoma by reducing the pressure in the eye (IOP or intraocular pressure).

Glaucoma is a very serious eye condition that occurs due to damage or injury on the optic nerve. This injury causes the affected person to experience vision problems, which progressively worsen. Glaucoma is a leading cause of irreversible blindness as it damages the nerve that connects the eye and brain, resulting in vision loss. 

In healthy eyes there is a constant flow of fluid in to and out of the eye which maintains a normal pressure in the eye. When there is glaucoma in the eye, a build up of this fluid causes a rise in pressure. This is most likely due to a blockage or clog in the pathway for the fluid to leave the eye. The resulting rise in pressure causes damage to the optic nerve. 

MIGS procedures are designed to improve the drainage of the fluid out of the eye.

“Minimally invasive” procedures means that your consultant surgeon will use very small incisions and microscopic equipment, which have been designed to reduce risk compared to other more traditional procedures such as a trabeculectomy.

MIGS procedures that are available include:

XEN Gel Stent

The XEN Gel Stent is new treatment option for those suffering from glaucoma. It is a small (as thin as a human hair) implant placed into the eye which is a small tube made of gelatin material. The stent is placed in to the eye and creates a new pathway for the fluid to leave the eye. This stent helps to keep the eye pressure at a normal level. XEN Gel Stent is very safe and effective and it is also less invasive than standard glaucoma treatments.

Hydrus

The Hydrus is a small (eyelash-sized) device. It is made of nickel and aluminium. The device is put into the main drainage channel of the eye (called Schlemm’s Canal). The Hydrus acts as a scaffold to hold the drainage channel open which allows the fluid in the eye to drain, reducing IOP. 

Preserflo

A Preserflo microshunt is a micro-tube which is inserted into the eye to lower pressure and is aimed to reduce the need for eye drops or medication. The Preserflo shunt is made of a synthetic material which is non-reactive and biocompatible called SIBS. The Preserflo cannot cure glaucoma, but it will significantly reduce the eye pressure and prevent any further damage to the optic nerve and further vision loss.

iStent

The iStent is made of titanium and it is a tiny (one millimetre) tube that is inserted into the natural drainage channel of the eye. It aims to bypass blockages in the drainage channel and therefore improves the flow of the fluid out of the eye and reduces IOP. It is common that a consultant ophthalmologist will use two or maybe even three iStent devices to improve the chances of a good reduction in IOP.

Whether your glaucoma symptoms are mild or advanced, our experts can provide state-of-the-art diagnostic services and a treatment plan tailored to your needs. With timely treatment and care, you will be able to prevent your eyesight from worsening and ensure you retain your ability to see. 

If you would like to discuss glaucoma treatment options with ophthalmology specialist Mr Vik Sharma please contact London OC and they will be happy to help.