Early Glaucoma Treatment: MIGS Options Explained by Christine Funke, MD

Glaucoma is a leading cause of irreversible blindness worldwide, affecting millions of people. Early detection and treatment are crucial to preserving vision and preventing further damage. One of the most promising advancements in glaucoma management is Minimally Invasive Glaucoma Surgery (MIGS). In this article, Dr. Christine Funke, MD, explains the benefits, types, and suitability of MIGS for early glaucoma treatment.

What Is Glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve, often due to elevated intraocular pressure (IOP). Without proper treatment, it can lead to progressive vision loss and blindness. There are several types of glaucoma, including:

Open-angle glaucoma – The most common form, where the drainage angle remains open but doesn’t function properly.

Angle-closure glaucoma – A less common but more urgent condition where the drainage angle becomes blocked.

Normal-tension glaucoma – Optic nerve damage occurs despite normal IOP levels.

Early intervention is key, and MIGS offers a safe and effective treatment option for many patients.

What Is MIGS?

Minimally Invasive Glaucoma Surgery (MIGS) refers to a group of surgical procedures designed to lower IOP with minimal trauma to the eye. Unlike traditional glaucoma surgeries, MIGS is:

Less invasive – Smaller incisions mean faster recovery.

Safer – Lower risk of complications compared to conventional surgeries.

Effective for early-stage glaucoma – Ideal for patients who haven’t yet developed severe disease.

MIGS procedures are often performed alongside cataract surgery, making them a convenient option for many patients.

Types of MIGS Procedures

There are several MIGS options available, each with unique benefits. Below are some of the most commonly used techniques:

1. iStent Inject®

The iStent Inject® is one of the smallest medical devices implanted in the human body. It works by creating a tiny bypass in the eye’s natural drainage system, improving fluid outflow and reducing IOP.

Key benefits:

Minimal downtime

Often combined with cataract surgery

Proven to reduce reliance on glaucoma medications

2. Hydrus® Microstent

The Hydrus® Microstent is a small, flexible device placed in Schlemm’s canal to enhance drainage. It helps maintain long-term IOP control.

Key benefits:

Scaffolds the eye’s natural drainage pathway

Reduces medication dependence

Safe and effective for mild to moderate glaucoma

3. XEN® Gel Stent

The XEN® Gel Stent is a soft, collagen-based implant that creates a new drainage channel for aqueous humor. It is often used for patients who need more significant IOP reduction.

Key benefits:

Lower IOP with fewer medications

Can be used in moderate to advanced glaucoma

Minimally invasive with a quick recovery

4. Trabectome®

The Trabectome® procedure uses an electrosurgical device to remove part of the trabecular meshwork, improving fluid drainage.

Key benefits:

Effective for open-angle glaucoma

Low complication rate

Can be repeated if necessary

Who Is a Good Candidate for MIGS?

MIGS is best suited for patients with:

Mild to moderate glaucoma

Open-angle glaucoma

Those seeking to reduce reliance on eye drops

Patients undergoing cataract surgery

However, MIGS may not be ideal for advanced glaucoma cases where more aggressive treatment is needed.

Advantages of MIGS Over Traditional Glaucoma Surgery

Compared to traditional glaucoma surgeries like trabeculectomy or tube shunts, MIGS offers several advantages:

Faster recovery – Most patients resume normal activities within days.

Lower risk of complications – Reduced chances of infection, scarring, or hypotony (abnormally low eye pressure).

Less postoperative care – Fewer follow-up visits compared to traditional surgeries.

What to Expect After MIGS

Recovery from MIGS is typically quick, but patients should follow their doctor’s instructions carefully. Common post-procedure guidelines include:

Using prescribed eye drops to prevent infection and inflammation

Avoiding strenuous activities for a few days

Attending follow-up appointments to monitor IOP

Most patients experience improved IOP within weeks, with minimal discomfort.

Conclusion

Early glaucoma treatment is essential to preserving vision, and MIGS provides a safe, effective, and minimally invasive option for many patients. With various procedures available, ophthalmologists like Dr. Christine Funke can tailor treatment to individual needs.

If you or a loved one has been diagnosed with glaucoma, consult a specialist to determine whether MIGS is the right choice. Early intervention can make all the difference in maintaining healthy vision for years to come.