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Minimally invasive glaucoma surgery is a group of implants, techniques, and devices that reduce the intraocular pressure, also called IOP or eye pressure. Glaucoma is a common eye condition affecting older people. It is caused by the accumulation of eye fluid called aqueous humour.
The fluid accumulation increases IOP, leading to damage to the optic nerve and vision loss. MIGS enhances drainage of eye fluid. This minimally invasive procedure means that only tiny incisions and microscopic equipment are necessary, reducing the procedure's risks, and faster recovery unlike other treatment options like aqueous tube shunt or trabeculectomy.
Below are common MIGS procedures.
This is a canaloplasty is a glaucoma surgery that cleans out the primary drainage channel in the eye. Ab-Interno simply describes the direction which the surgeons access the main drainage from. In this procedure, the surgeon accesses the main drainage from the front of the eye, in front of the pupil, instead of using the side of the eye.
iTrack is a small tube inserted through the drainage channel. The surgeon will insert a special gel through the catheter to open the drainage and break down blockages in the drainage channel. This helps fluid flow out of the eye, reducing eye pressure.
ECP is a laser that targets the ciliary body (the eye part that produces the eye fluid). The laser minimises activity in the ciliary body, resulting in less fluid production and reduction of IOP. This procedure gives a temporary effect and requires repeated treatments as the ciliary body recovers.
The Hydrus is a small device inserted in the main drainage eye channel, known as Schlemm's Canal. This eyelash-sized device made of aluminium and nickel acts as a scaffold to open the drainage channel. This allows eye fluid to drain, reducing eye pressure.
iStent is one millimetre-sized tube inserted into the eye's drainage channel. This tube made of titanium bypasses the blockage in the eye's channel, improving fluid flow out of the eye and reducing eye pressure.
Some people have 2 – 3 iStents implanted in the eye to increase the chances of significantly reducing IOP.
The Preserflo Micro shunt is a tiny tube implanted in the eye to create a new pathway for fluid drainage. The fluid acts as a bypass, allowing excess fluid to drain into a small blister, known as the bleb, under the eye's surface (conjunctiva), just under the eyelid. This procedure enhances fluid drainage in the eye, reducing IOP.
This procedure involves using an electric pulse to remove a part of the blocked drainage channel, helping the natural drainage pathway work again. The result is better fluid drainage in the eyes and lower IOP.
This small tube made from porcine gelatine is inserted into the eye to make a new drainage path for the fluid. The implant serves as a bypass, with excess fluid drainage to a bleb under the eye's surface, beneath the upper eyelid. The result is better fluid drainage in the eye, leading to lower IOP.
The Cy-Pass Micro-Stent is a tiny tube inserted in the eye to bypass the main fluid drainage channel and enhance the function of another natural drainage channel. This results in improved fluid drainage from the eyes and a reduction in IOP. This stent is made from special plastic.
This MIGS method became unavailable in 2018 due to the research that found the procedure to increase the risk of losing cornea cells. People who had this stent implanted are unlikely to remove it as it may damage the eye.
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