Update on Minimally Invasive Glaucoma Surgery (MIGS) and New Implants

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Background:

• Traditional glaucoma surgeries like trabeculectomy carry risks of serious complications.
• There is a growing need for safer surgical options to manage intraocular pressure (IOP) and enhance patient quality of life.
• Minimally Invasive Glaucoma Surgery (MIGS) has emerged as a promising alternative.

Purpose of the Study:

• To review the clinical outcomes of the latest MIGS techniques and devices.
• To compare the safety and efficacy profiles of MIGS with traditional glaucoma surgery.
• To discuss the current role of MIGS in glaucoma treatment.

Main Methods:

• Review of ab interno MIGS procedures including trabeculotomy, excimer laser trabeculotomy, trabecular microbypass, suprachoroidal shunt, and intracanalicular scaffold.
• Review of ab externo MIGS procedures including canaloplasty, Stegmann Canal Expander, and suprachoroidal Gold microshunt.
• Analysis of clinical results focusing on IOP reduction and safety profiles.

Main Results:

• MIGS procedures are generally nonpenetrating and bleb-independent, reducing risks associated with traditional surgery.
• Various MIGS techniques demonstrate varying degrees of IOP reduction, with some offering less reduction compared to trabeculectomy.
• MIGS is currently indicated for early to moderate glaucoma, often performed concurrently with cataract surgery.

Conclusions:

• MIGS represents a significant advancement in glaucoma surgery, offering improved safety.
• While effective, the IOP-lowering potential of some MIGS may be limited compared to trabeculectomy.
• MIGS is a valuable option for specific glaucoma patient populations, particularly when combined with cataract surgery.