New Surgical Options for Glaucoma Patients

When it comes to treating eye disease, therapies must be delicate and precise. This is especially the case with glaucoma, a family of eye diseases that damages the optic nerve. Current glaucoma treatments all have one goal in mind: to reduce intraocular pressure (IOP) to minimize strain on the optic nerve. There is no cure for glaucoma, so the only way to treat the disease is to manage eye pressure.

For years, doctors relied on surgical procedures like trabeculectomy and external tube-shunts. These methods have been effective in slowing the progression of glaucoma, but each procedure is accompanied by risk and possible complications. Because most candidates for glaucoma surgery were faced with losing even more of their vision if they did not choose surgery, the risk seemed worthwhile.

Today, glaucoma patients have much more choice in treatments and therapies. Minimally invasive glaucoma surgery (MIGS) uses microscopic-sized equipment and small incisions to reduce complications and lower intraocular pressure.

The MIGS group of operations is divided into several categories:

  • Miniaturized versions of trabeculectomy—Xen Gel Stent and InnFocus Microshunt use tiny, microscopic-sized tubes that can be inserted into the eye and drain fluid from inside the eye to underneath the outer membrane of the eye.
  • Trabecular bypass operations—using a special lens on the eye, a small device is inserted into the eye through a tiny incision into the trabecular meshwork under high power microscopic control.
  • Totally internal or suprachoroidal shunts—tiny tubes connect the front of the eye to the suprachoroidal space between the retina and the wall of the eye.
  • Milder, gentler versions of laser photocoagulation—laser procedures are no longer reserved for patients with advanced glaucoma.

There are many advantages of MIGS, giving glaucoma patients and doctors more treatment options. One downside of MIGS is that some degree of effectiveness is exchanged for reduced incidence of complications. However, the added safety is a significant benefit for glaucoma patients who are younger and do not have advanced vision loss. Most physicians use the safer MIGS procedures to prevent their patients from progressing to the point where they need the higher risk traditional glaucoma surgeries (Source:


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