Delhi Journal of Ophthalmology

Minimally Invasive Glaucoma Surgery (MIGS)

Meena G Menon, Shalini
Department of Glaucoma, Sankara Eye Hospital, Bengaluru, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.

Corresponding Author:

Department of Glaucoma
Sankara Eye Hospital, Bengaluru, India.

Received: 03-SEP-2020 Accepted: 07-DEC-2020 Published Online: 09-JUL-2021

Glaucoma, a chronic progressive optic neuropathy, is the second leading cause of irreversible blindness world-wide. The only treatable risk factor till date is lowering of intra-ocular pressure (IOP), thus, being the mainstay of treatment. Constant search for alternative surgical means for effective, sustainable reduction of IOP with higher safety profile, an ab- interno approach causing minimal trauma to ocular tissues, faster recovery with minimum impact on quality of life has led to a new class of procedures named Minimally Invasive/ Micro-invasive Glaucoma Surgery (MIGS). MIGS can act by bypassing any obstruction at the trabecular meshwork (iStent, Hydrus micro-stent, Trabectome, Kahook dual blade goniotomy), by enhancing aqueous outflow through Schlemm’s canal (Ab interno Canaloplasty) or through the supra-choroidal space (iStent supra). They can also act through shunting aqueous outflow into the sub-conjunctival space (XEN gel implant) or by reducing aqueous production by ciliary body ablation (endo-cyclo-photocoagulation). The revolutionary MIGS comprising several different procedures and devices can be staggering for the glaucoma specialists. The aim of the present review is to provide an understanding of the currently available classes of MIGS encompassing the design, safety and efficacy profile to help the ophthalmologists to tailor the surgical approaches for greater individual care.

Keywords :MIGS, Intra-Ocular Pressure, Trabecular Meshwork Bypass, Supra-Choroidal Stent, Sub- Conjunctival Implant

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