Minimally Invasive Glaucoma Surgery
- Feb 3
- 2 min read
Updated: Mar 3
Minimally Invasive Glaucoma Surgery, or MIGS, is a safer, less invasive way to treat glaucoma in selected patients. It won’t cure glaucoma, but it can help control eye pressure and protect vision, often with fewer medications and quicker recovery.
What is the purpose of MIGS?
To lower the eye pressure, thus reducing the need for glaucoma eye drops, in a manner that causes less tissue damage as compared to traditional glaucoma surgery.
How is this done?
MIGS aims to improve the drainage of fluid from the eye, or to reduce the amount of fluid the eye generates.
For instance, the iStent is a trabecular microbypass stent that improve drainage of fluid from the eye by placing a tiny titanium stent right where the drainage pathway is (this is called the Schlemm's Canal), in order to help fluid drain more easily. Think of this as keeping the Bukit Timah Canal open and free of any blockages, allowing rainwater to flow quickly and unobstructed.
Another product, the Hydrus Microstent works in the same manner, but using nitinol, a metal alloy, as the stent material, acting as a bypass and scaffold to allow fluid drainage to happen more freely.
Using a different method, the XEN Gel Stent or XEN Gel Implant, aims to improve drainage of the fluid from the eye using a seperate pathway - by drainaing out of the internal portion of the eye and into the subconjunctival space which is the thin transparent tissue layer on the white part of the eye. This is achieved through the implant of a flexible gelatin tube.
Endoscopic Cyclophotocoagulation (ECP) aims to control the eye pressure by reducing the amount of fluid production within the eye, and this is achieved by using a laser to ablate a portion of the fluid-producing tissue called the Cilliary Body
What's the difference from the 'normal' glaucoma surgery?
In traditional surgeries (such as trabeculectomy or tube shuts), larger incisions are involved, which can mean a longer recover time and higher risks. MIGS procedures uses smaller incisions and are typically quicker to perform with a faster recovery time for the patient, which also leads to a lowered risk of complications.
Can MIGS be combined with other procedures?
MIGS can be done together with cataracts-removal surgery, or as a standalone procedure, and is often done on an 'outpatient' basis, that is, you get to go home quite quickly after the procedure is over, without hospitalisation stay.
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