All about minimally invasive glaucoma surgery

Written by: Miss Anna Mead
Edited by: Conor Lynch

In this article below, experienced and highly skilled consultant ophthalmologist, Miss Anna Mead, explains what MIGS is, describes how this surgery is normally performed, and details what patients can expect after the surgery.

What is minimally invasive glaucoma surgery?

Minimally invasive glaucoma surgery (MIGS) is a group of various different surgeries used to treat glaucoma.


How is it performed?

MIGS sees the ophthalmologist insert tiny incisions in the patient’s eye. This reduces trauma to ocular tissues.


The surgery is performed using various techniques, with each one designed to improve aqueous outflow and reduce intraocular pressure (IOP). So, how is MIGS performed? Well firstly, the patient is positioned appropriately, and local anaesthesia is administered. Then, a small corneal or scleral incision is made, which allows the surgeon to gain access to the anterior chamber of the eye.


What are the different types of MIGS?

There are many types of minimally invasive glaucoma surgery. They are:


  1. Trabecular meshwork bypass: Microstents (e.g., iStentHydrus) are inserted into the trabecular meshwork to enhance aqueous drainage.
  2. Schlemm’s canal procedures:Devices like Visco 360/OMNI or Ab Interno Canaloplasty (ABiC) are used to dilate Schlemm’s canal.
  3. Suprachoroidal space procedures:The CyPass Micro-Stent is placed to redirect fluid into the suprachoroidal space.
  4. Subconjunctival shunts: The XEN Glaucoma Implant facilitates drainage into the subconjunctival space.
  5. Ciliary Body Ablation: Endocyclophotocoagulation (ECP) uses laser energy to reduce aqueous production.


Whichever the specific procedure, the incision in the eye is closed using sutures or self-sealing techniques.


What does post-operative care following MIGS entail?

Patients receive instructions for eye care, including antibiotic and anti-inflammatory eye drops. Regular follow-up visits monitor IOP and healing. MIGS procedures typically have shorter recovery times compared to traditional glaucoma surgeries.


What conditions is MIGS suitable for?

This minimally invasive glaucoma surgery is suitable for mild to moderate glaucoma cases.


If you’d like to make an appointment for an eye concern that you might have with Miss Anna Mead, then you can do so via her Top Doctors profile today. 

By Miss Anna Mead

Miss Anna Mead is a consultant ophthalmologist with exceptional knowledge and skill. She provides patients with support for a wide range of eye symptoms and conditions, most notably cataracts and glaucoma.
Miss Mead is an expert in general ophthalmology as well as specialist surgeries. She regularly performs routine and complex procedures including cataract surgery and lens replacement using intraocular lenses (IOLs). She also performs glaucoma surgeries, including MIGS (minimally invasive glaucoma surgery) and laser treatment for glaucoma.
Her undergraduate training took place at Robinson College, Cambridge, and she qualified with honours from Cambridge University Clinical School. Following her studies, she trained at several prominent eye clinics, including Moorfields Eye Hospital, a specialist NHS eye hospital, which is where she combined her clinical training with academic research by completing a PhD in glaucoma surgery. This research has led her to publish and present her work at national and international meetings.

Miss Mead has significant teaching and training experience. Among her many positions, she is currently the Head of the School for Ophthalmology for Health Education England Thames Valley (HEETV), has been a college tutor for Buckinghamshire Healthcare NHS Trust and was the HEETV Lead for Simulation tutor at the Royal College of Ophthalmologists. Here, she still provides support for struggling trainees in her Communication in Education role. 

Private patients can access Miss Mead’s outstanding care at her clinics in Great Missenden, Aylesbury and High Wycombe. She also dedicates her practice to the public sector at the Buckinghamshire NHS Trust, from which she has received a Clinical Excellence Award for her commitment to first-rate patient care.

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