Micro-Incisional Glaucoma Surgery
MIGS procedures offer effective pressure reduction with faster recovery times and fewer complications than traditional glaucoma surgery. These techniques can often be performed during cataract surgery, addressing both conditions simultaneously. There are different types of MIGS procedures.
Trabecular Meshwork Bypassing Stents Implantation
iStent®
The iStent is one of the smallest medical implants in the world, designed to be placed inside and bypass the eye’s natural drainage system (the trabecular meshwork) to improve fluid outflow.
iStent infinite®
The iStent infinite builds on the original iStent technology. Instead of a single device, it includes three stents placed in different areas of the eye’s drainage system for a more comprehensive approach. This design helps provide additional eye pressure reduction for patients, even when they have more advanced diseases. iStent infinite can be performed independent of cataract surgery.
Hydrus® Microstent
The Hydrus Microstent is a tiny, flexible device inserted into the eye’s drainage canal (Schlemm’s canal). The Hydrus acts like a “scaffold,” expanding and holding the canal open for about 90 degrees. This allows fluid to flow out more easily, reducing eye pressure.
Angle Based, Implant-free Procedures
Goniotomy
Goniotomy is a micro-incisional glaucoma surgery (MIGS) that helps lower eye pressure by improving the eye’s natural fluid drainage. During the procedure, the surgeon gently opens the trabecular meshwork (the tissue that can become blocked in glaucoma). By creating this opening, fluid can flow out more easily, which helps reduce pressure inside the eye. Goniotomy can be performed on its own or at the same time as cataract surgery. Because it does not involve placing an implant, it is considered an implant-free option for treating glaucoma.
Goniotomy can be performed with a variety of devices, which are all being utilized at Harvard Eye Associates:
- Trabectome
- OMNI surgical system
- Via360
- Kahook Dual Blade
- TrabEx
- iAccess
Canaloplasty
Canaloplasty is a micro-incisional glaucoma surgery (MIGS) designed to lower eye pressure by improving the eye’s natural drainage system. During the procedure, a tiny microcatheter is inserted into Schlemm’s canal (the circular drainage canal around the eye) and threaded around its full length, allowing fluid to drain more easily. Unlike traditional glaucoma surgery, canaloplasty is implant-free.
Canaloplasty can be performed with a variety of devices offered here at Harvard Eye Associates:
- OMNI surgical system
- Streamline
Bleb-forming Procedures
Xen Gel Stent
The Xen Gel Stent is a tiny, soft, tube-like implant designed to lower eye pressure in people with glaucoma. It creates a new pathway for fluid to drain from inside the eye to a small reservoir under the conjunctiva (the thin membrane covering the eye), bypassing the eye’s natural drainage system when it is blocked.
The procedure is minimally invasive, and can be done with or without cataract surgery.
