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Microinvasive Glaucoma Surgery: An Evidence-Based Review.

Faith A Birnbaum1, Cameron Neeson1, David Solá-Del Valle1

  • 1Department of Ophthalmology, Glaucoma Service, Massachusetts Eye and Ear Infirmary, Boston, MA United States.

Seminars in Ophthalmology
|July 23, 2021
PubMed
Summary

Micro-invasive glaucoma surgery (MIGS) is increasingly popular and generally safe. More large-scale studies are needed to compare different MIGS procedures for optimal glaucoma treatment.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Medical Devices

Background:

  • Micro-invasive glaucoma surgery (MIGS) has seen a significant rise, with a 400% increase in procedures in the US.
  • MIGS encompasses a variety of surgical techniques for glaucoma management.
  • This review specifically examines evidence for Trabectome®, iStent inject®, Kahook Dual Blade®, XEN® Gel Stent, and Hydrus®.

Purpose of the Study:

  • To review peer-reviewed evidence on the efficacy and safety of specific MIGS procedures.
  • To evaluate MIGS in patients with varying types and stages of glaucoma.
  • To provide insights for ophthalmologists considering MIGS in their surgical practice.

Main Methods:

  • Review of key recent studies on MIGS efficacy and safety.
  • Focus on peer-reviewed evidence for selected MIGS devices.
Keywords:
HydrusKahook Dual BladeMicro-invasive glaucoma surgery (MIGS)Minimally invasive glaucoma surgery (MIGS)Xen Gel StentgoniotomyiStentiStent inject

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  • Analysis of studies involving diverse glaucoma patient populations and disease severities.

    • Main Results:

    • MIGS procedures demonstrate general safety and efficacy.
    • Evidence base varies, with only some MIGS having undergone randomized clinical trials.
    • Comparative data across different MIGS procedures is limited by a lack of large prospective studies.

    Conclusions:

    • MIGS is a generally safe and effective surgical option for glaucoma.
    • Further high-quality, large-scale prospective studies are crucial for comparative analysis.
    • Such studies will aid ophthalmologists in integrating MIGS into their surgical armamentarium.