Minimally Invasive Glaucoma Surgery (MIGS)

Minimally Invasive Glaucoma Surgery (MIGS)

Ophthalmology Services

What is Minimally Invasive Glaucoma Surgery (MIGS)?

Glaucoma is a group of eye disorders that cause damage to the optic nerve, which is a nerve essential for good vision. Excessively high pressure in your eye is usually the source of this damage.

Glaucoma can happen at any age, but it is more common among the elderly. It is one of the primary causes of blindness among adults over the age of 60.

As vision loss due to glaucoma is irreversible, it is crucial to have frequent eye exams that include measurements of your eye pressure so that a diagnosis can be made, and proper treatment may be administered.

Vision loss caused by glaucoma can be slowed down or prevented if detected early. If you have the disease, you will almost certainly require treatment for the rest of your life.

There are various treatments available to treat glaucoma. Depending on the severity of the disease, treatments may include oral medications, prescription eye drops, laser treatment, surgery or a combination of any of these.

What is Minimally Invasive Glaucoma Surgery (MIGS)?

Glaucoma is a group of eye disorders that cause damage to the optic nerve, which is a nerve essential for good vision. Excessively high pressure in your eye is usually the source of this damage.

Glaucoma can happen at any age, but it is more common among the elderly. It is one of the primary causes of blindness among adults over the age of 60.

As vision loss due to glaucoma is irreversible, it is crucial to have frequent eye exams that include measurements of your eye pressure so that a diagnosis can be made, and proper treatment may be administered.

Vision loss caused by glaucoma can be slowed down or prevented if detected early. If you have the disease, you will almost certainly require treatment for the rest of your life.

There are various treatments available to treat glaucoma. Depending on the severity of the disease, treatments may include oral medications, prescription eye drops, laser treatment, surgery or a combination of any of these.

What is Minimally Invasive Glaucoma Surgery (MIGS)?

Minimally invasive glaucoma surgery (MIGS) constitutes a group of surgical interventions that are safe, quick, and with minimal tissue disruption. This allows rapid recovery for patients.

MIGS works by increasing aqueous outflow or drainage inside the eye and thus helps to reduce intraocular pressure (IOP). Some MIGS decrease aqueous production by laser ablation of the ciliary body (a structure that produces aqueous).

Minimally Invasive Glaucoma Surgery (MIGS) Procedures at EYECENTRIC

MIGS operations are classified into categories based on how they reduce intraocular pressure. Below are some MIGS procedures that we offer at EYECENTRIC:

Minimally Invasive Glaucoma Drainage Surgery - Improving your eyes' natural drainage system, known as the trabecular meshwork

iStent Trabecular Micro-Bypass Stent

The iStent is the world's tiniest implantable device that has been approved for use in the human body. It is a titanium device implanted at two distinct locations in the front of your eye to produce two bypasses that improve ocular fluid outflow through your eye's natural drainage system. Typically, the iStent is inserted during cataract surgery. The majority of participants in clinical trials of the second-generation iStent Inject were medication-free after 23 months. Because the stent is made of titanium, you can undergo MRI scans without fear of metal implants.

Glaucoma Drainage Implant (Tube Shunt Surgery)

Tube shunt surgery can prevent loss of vision by lowering your eye pressure. During the procedure, a tube shunt device will be inserted into the front chamber of your eye. The device is made up of a tube and a plate, the excess fluid will be drained through the tube into the back end of the plate. The collected fluid on the plate will be drained through the eye’s natural drainage system.

Laser Surgery - To lower intraocular pressure (IOP) of the eye and regulate the flow of fluid in the eye

Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) is a form of minimally invasive glaucoma surgery. It is used to lower IOP in glaucoma, preventing further vision damage. Our highly trained ophthalmologists will first insert a special contact lens to keep your eyelids open. Anaesthetic eye drops will then be administered into your eyes followed by a laser. The laser is applied directly to the drainage system of the eye. The procedure stimulates a biochemical change that maintains the flow of fluid in the eye.

Laser Peripheral Iridotomy (LPI)

Laser Peripheral Iridotomy (LPI) is a preferred procedure to treat closed-angle glaucoma. In closed-angle glaucoma, a pupillary block prevents the fluid from flowing into the anterior chamber from the posterior chamber. In LPI, an opening in the iris is made with a laser to allow the fluid to drain normally, bypassing the block.


Only patients with mild or moderate severity glaucoma are eligible to undergo MIGS procedures given its limited efficacy in IOP reduction. Some MIGS procedures are performed in combination with cataract surgery. MIGS help to reduce eye drops dependence (good for patients intolerant of noncompliance with eye drops) and among patients whose IOP is not well controlled with typical eye drops.

However, MIGS are often not a sufficient treatment for patients with more advanced glaucoma who require a low IOP goal. Traditional incisional surgeries such as glaucoma drainage implants or trabeculectomy are still the gold standard for effective IOP reduction.

Treatment of glaucoma is individualised. It depends on the type of glaucoma, IOP, patient’s visual prognosis, patient’s general health condition and life expectancy.

If you experience any symptoms that you feel might lead to glaucoma, visit our eye specialist centre, EYECENTRIC at Subang Jaya Medical Centre (SJMC) for a check-up and consultation with our team of experts to discuss your treatment plan. Our team of highly experienced eye surgeons also offer a range of services, from surgery to fix cataracts to treatment of retinal disorders like retinal detachment and macular degeneration.

Meet our Specialist

Dato’ Dr Linda Teoh Oon Cheng

Designation
Consultant Ophthalmologist and Glaucoma Surgeon
Specialty
Ophthalmology






Dr Lee Ming Yueh

Designation
Consultant Ophthalmologist and Glaucoma Surgeon
Specialty
Ophthalmology