Visual Function After Schlemm's Canal-Based MIGS.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Minimally Invasive Procedures

Background:

• Filtration surgery effectively lowers intraocular pressure but carries risks of severe complications and visual dysfunction.
• Minimally invasive glaucoma surgery (MIGS) is increasingly preferred for early- to moderate-stage glaucoma due to its safety profile and preservation of visual function.
• Canal-opening MIGS (CB-MIGS) targets aqueous outflow through Schlemm's canal, avoiding conjunctival/scleral manipulation and reducing severe complication risks.

Purpose of the Study:

• To review and summarize the literature on visual function following CB-MIGS.
• To assess postoperative changes in best-corrected visual acuity (BCVA), refraction, and astigmatism after CB-MIGS.
• To evaluate the effectiveness of CB-MIGS in preserving visual field function.

Main Methods:

• Literature review of studies reporting visual function outcomes after CB-MIGS.
• Focus on changes in BCVA, refractive error, astigmatism, and visual field progression.
• Analysis of complications, particularly hyphema, and their impact on vision.

Main Results:

• Hyphema is the main cause of early vision loss but is often transient.
• Severe vision-threatening complications are rare with CB-MIGS.
• Postoperative visual recovery is generally faster than with filtration surgery, with induced astigmatism comparable to standalone cataract surgery. Refractive outcomes are similar when combined with cataract surgery, though mild hyperopic shifts can occur.

Conclusions:

• CB-MIGS is a safe and effective option for suitable glaucoma patients, offering good visual function preservation.
• While short- to medium-term visual field progression is often suppressed, more large-scale, long-term studies are needed.
• Further research should focus on long-term outcomes and larger prospective studies to solidify evidence for CB-MIGS effectiveness.