Our Summary

The popularity of micro-invasive glaucoma surgery (MIGS), a less invasive type of eye surgery to treat glaucoma, has increased by at least 400% in the US over the past 8 years. This research paper investigates the effectiveness and safety of different types of MIGS, such as Trabectome, iStentinject, Kahook Dual Blade, XEN Gel Stent, and Hydrus. The researchers have looked at recent studies on patients with various types of glaucoma and stages of the disease. The findings suggest that MIGS is generally safe and effective. However, only some types of MIGS have been studied in randomized clinical trials. Large, high-quality studies on MIGS have not been common, and the researchers suggest that these types of studies are a crucial next step as eye doctors decide how to include MIGS in their range of surgical treatments.

FAQs

  1. What is micro-invasive glaucoma surgery (MIGS) and how has its popularity increased in the US?
  2. What types of MIGS were investigated in the research paper and what were the findings regarding their safety and effectiveness?
  3. Why are large, high-quality studies on MIGS considered crucial by researchers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about glaucoma surgery is to discuss with them the various types of MIGS available and their potential benefits and risks. It is important for patients to be informed about their options and to have a thorough discussion with their doctor about which type of surgery may be most suitable for their individual situation. Additionally, patients should follow their doctor’s post-operative care instructions closely to ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended glaucoma surgery include those with:

  • Open-angle glaucoma
  • Narrow-angle glaucoma
  • Secondary glaucoma (e.g., due to diabetes or trauma)
  • Patients who have not responded well to medication or laser treatments
  • Patients who have advanced stages of glaucoma and are at risk of losing vision
  • Patients who are looking for a less invasive surgical option
  • Patients who have a combination of cataracts and glaucoma and are seeking a combined procedure to address both issues.

Timeline

Before glaucoma surgery:

  1. Patient is diagnosed with glaucoma through routine eye exams and tests.
  2. Patient undergoes various treatments such as eye drops, laser therapy, or oral medications to manage the condition.
  3. If these treatments are not effective in controlling the progression of glaucoma, the patient may be recommended for glaucoma surgery.

After glaucoma surgery:

  1. Patient undergoes pre-operative evaluations and tests to determine the best surgical approach for their specific case.
  2. The patient undergoes the glaucoma surgery, which may involve the insertion of a small device or stent to improve the drainage of fluid from the eye.
  3. Post-operative care includes regular follow-up appointments with the eye doctor to monitor the healing process and ensure the surgery was successful.
  4. Patient may experience some discomfort, blurry vision, or light sensitivity in the days following surgery, but these symptoms typically improve over time.
  5. Patient may be advised to continue using eye drops or other medications to manage intraocular pressure and prevent complications.
  6. Over time, the patient’s vision should improve, and they may experience a reduction in symptoms associated with glaucoma. Regular monitoring and check-ups will be necessary to ensure the long-term success of the surgery.

What to Ask Your Doctor

  1. What type of glaucoma do I have and is MIGS a suitable option for me?

  2. What are the potential benefits of MIGS compared to traditional glaucoma surgery?

  3. What are the potential risks and complications associated with MIGS?

  4. How long is the recovery process after MIGS and what should I expect during this time?

  5. Are there any specific factors that may make me a better or worse candidate for MIGS?

  6. How many MIGS procedures have you performed and what is your success rate?

  7. Will I still need to use glaucoma medications after MIGS?

  8. How long can I expect the effects of MIGS to last?

  9. Are there any lifestyle changes or precautions I should take after MIGS?

  10. Are there any alternative treatment options to consider before deciding on MIGS?

Reference

Authors: Birnbaum FA, Neeson C, Solá-Del Valle D. Journal: Semin Ophthalmol. 2021 Nov 17;36(8):772-786. doi: 10.1080/08820538.2021.1903513. Epub 2021 Jul 23. PMID: 34297650