Minimally Invasive Glaucoma Surgery (MIGS)
Understanding MIGS
This section explains how MIGS works and why many patients prefer it over older surgical options.
MIGS is a group of advanced procedures that lower intraocular pressure by enhancing or modifying the eye’s drainage system. By using very small instruments, surgeons can reduce pressure without large incisions.
The procedures either improve fluid flow through natural pathways or reduce the amount of fluid the eye produces. Both methods protect the optic nerve from further damage.
MIGS involves smaller cuts, causes less tissue disruption, and carries fewer risks. Patients usually go home the same day and return to normal activities sooner.
Many MIGS devices can be implanted during cataract surgery using the same incision. This combined approach addresses two eye problems in one procedure.
Candidacy and Benefits
Not every patient is a candidate for MIGS, so our specialists evaluate each case carefully.
MIGS is most helpful for people with mild to moderate primary open-angle glaucoma who need a modest pressure reduction or have trouble with daily eye drops.
Patients with advanced glaucoma who require very low pressure may still need traditional incisional surgery for the best outcome.
Patients often choose MIGS for its many benefits.
- Smaller incisions result in faster healing.
- Lower risk of serious complications.
- Possible reduction or elimination of glaucoma medications.
- Can be performed with cataract surgery for added convenience.
MIGS manages glaucoma but does not cure it. Lifelong follow-up care is essential to monitor pressure and protect vision.
Types of MIGS Procedures
Several techniques fall under the MIGS umbrella, each targeting a different part of the eye’s drainage system.
These devices create a direct path for fluid to enter Schlemm’s canal.
- iStent and iStent Inject are tiny titanium implants that lower pressure, often implanted during cataract surgery.
- Hydrus Microstent is made of flexible nitinol and helps keep Schlemm’s canal open in mild to moderate glaucoma.
Some procedures remove part of the trabecular meshwork without leaving an implant.
- Kahook Dual Blade (KDB) goniotomy excises a strip of tissue to improve flow.
- Trabectome removes meshwork using electrocautery while irrigating the area.
- Gonioscopy Assisted Transluminal Trabeculotomy (GATT) opens the entire meshwork using a microcatheter or suture.
These methods expand Schlemm’s canal to enhance outflow.
- VISCO360 or the OMNI System combines viscodilation with trabeculotomy.
- Ab Interno Canaloplasty (ABiC) threads a microcatheter through the canal and injects viscoelastic material.
For some eyes, fluid is redirected outside traditional pathways.
- XEN Gel Stent moves fluid into the subconjunctival space for absorption.
- Research continues on safe suprachoroidal approaches to use the uveoscleral outflow route.
Instead of improving drainage, certain procedures lower fluid creation.
- Endocyclophotocoagulation (ECP) uses a laser to treat the ciliary body and decrease fluid production.
The Surgical Experience
Knowing what to expect helps patients feel more comfortable about surgery and recovery.
Your eye is numbed with local anesthesia, and the surgical plan is reviewed to ensure comfort and safety.
The surgeon makes tiny incisions and inserts micro-devices to improve drainage. Most procedures are completed in an outpatient setting.
It is normal to have mild discomfort or blurry vision for a short period. Anti-inflammatory and antibiotic eye drops help the eye heal.
Regular visits allow your doctor to monitor pressure, adjust medications, and confirm that the device or treated area is working as intended.
Our Approach to Glaucoma Management
Westwood Ophthalmology Associates is committed to providing the right care at the right time for every patient.
Our team collaborates to design individualized strategies that match each patient’s needs, goals, and lifestyle.
We offer the most advanced treatments, including participation in FDA clinical studies such as those for iDose TR.
Our specialists teach at leading universities and work closely with referring doctors, earning the trust of patients across North Jersey.
Frequently Asked Questions
These answers address common concerns about MIGS and glaucoma care.
No. MIGS uses small devices or surgical techniques through tiny incisions, while laser surgery like selective laser trabeculoplasty uses laser energy without implants or cuts.
MIGS does not cure glaucoma. It slows disease progression by lowering pressure, and ongoing monitoring remains necessary.
Results vary by patient, but many people enjoy lower intraocular pressure for years. Because glaucoma is progressive, routine follow-up visits are important.
Regular appointments allow our specialists to check pressure, watch for complications, and adjust medications. Some patients reduce or stop drops, while others continue them at lower doses.
Take the Next Step Toward Healthier Vision
If you have glaucoma or have been told you may need surgery, our ophthalmologists are ready to help you explore whether MIGS or another treatment is right for you. We proudly serve patients from Bergen, Morris, and Passaic Counties, as well as the greater NYC area, and look forward to supporting your long-term eye health.
Dr. Chin is kind, professional, and provides thorough care. I recently had laser surgery for glaucoma and I’m very pleased with the results.
Michele Cucci
Dr. Chin is kind, professional, and provides thorough care. I recently had laser surgery for glaucoma and I’m very pleased with the results.
Michele Cucci
Patient for 20 years. Dr. Chin always listens to concerns and explains what to expect as my eyes age. He’s knowledgeable and patient. I have recommended Dr. Chin to family and friends.
Anne Lembersky
My mother saw Dr. Fleischer on an emergency basis, and he could not have been more helpful or professional. He was so patient, and extremely gentle while examining her eyes.
Lisa M
I'm always comfortable with the doctor since my cataract surgery 2 years ago. Outstanding bedside manner. I’ve been a patient of Westwood Ophthalmology for 20 years and would never consider another group.
Joseph Tamberelli