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    Minimally invasive glaucoma surgery (MIGS)

    Dr Jed Lusthaus

    Minimally invasive glaucoma surgery (MIGS) is a new option for patients with glaucoma. A tiny drainage device is inserted into or through the eye’s internal drain to reduce intraocular pressure (IOP). There are multiple device options including iStent, Hydrus Micro-stent, Xen Gel Stent, and CyPass Micro-stent.
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    MIGS offers safer and more surgical options for the treatment of glaucoma. Please discuss with your surgeon whether MIGS is suitable for you.

    Devices that enhance the eye’s natural drainage system:The iStent and Hydrus Micro-stent can be inserted at the end of cataract surgery to enhance the eye’s natural fluid (aqueous) drainage. Both of these stents may be suitable for patients who have the combination of mild-moderate glaucoma and cataract. Insertion of iStent or Hydrus Micro-stent may lower the IOP sufficiently to enable some or all glaucoma drops to be stopped. The safety profile for these devices is excellent.

    Devices that bypass the eye’s natural drainage system:The Xen Gel Stent and CyPass Micro-stent create an alternate pathway for aqueous to exit the eye. The Xen Gel stent diverts fluid to an area underneath the top eyelid. The CyPass Micro-stent diverts fluid into a deeper area within the middle layers of the eye wall. Both of these devices have the ability to lower IOP significantly, but have the potential for a slightly higher complication rate. These devices are generally reserved for patients with more advanced or aggressive glaucoma. They can be combined with cataract surgery or used as an individual procedure.