Minimally Invasive Glaucoma Surgery (MIGS)
Minimally-invasive glaucoma surgery encompasses new devices that seek to lower eye pressure and is best suited for patients with mild to moderate glaucoma. It is is often performed in conjunction with cataract surgery. Its advantages are less surgical manipulation and risk, and faster recovery.
All MIGS procedures have the following characteristics that distinguish them from traditional glaucoma surgery:
‘Minimally traumatic’ to eye structures
Performed within the eye and hence preserves the conjunctiva, the eye’s natural lining
High safety profile
Relatively quick with rapid recovery
Frequently combined with cataract surgery
Multiple treatments are possible
MIGS involves placement of a microscopic stent that allows fluid to escape from the eye. If combined with cataract surgery, adding a glaucoma stent at the end of the operation adds little risk and may reduce or stop your need for glaucoma drops. Dr Yun offers the two most popular and established devices in Australia – the iStent and Hydrus devices.
The iStent Inject
Figure. The iStent inject.
The iStent inject is exciting new technology available for patients with open angle glaucoma. It consists of two small titanium stents less than 0.5mm in length – the smallest ever medical implant! The stents are implanted inside the eye to help drain fluid from your eye, resulting in lowered eye pressure. It works by creating a new permanent drainage pathway.
The iStent is best suited for patients with mild to moderate open angle glaucoma who are having cataract surgery. It is highly effective in slowing the progression of glaucoma and preventing vision loss. Best of all, there is a high safety profile and post-operative management is the same as with regular cataract surgery.
The Hydrus Microstent
Figure. The Hydrus microstent.
The Hydrus microstent is an innovative new device for patients with open angle glaucoma. It is approximately the size of an eyelash (8mm) and made of a metallic alloy called Nitinol.
The Hydrus device is inserted into the primary fluid drainage canal (Schlemm’s canal) of the eye. It acts as a scaffold to open the channel and enable fluid to flow more freely out of the eye. As a result, the eye pressure is lowered and glaucoma progression is halted.
The Hydrus microstent is typically performed at the time of cataract surgery, using the same microincisions. It has a better safety profile and faster healing time than traditional glaucoma surgery.