Minimally Invasive Glaucoma Surgery: A Critical Appraisal of the Literature
Abstract
Micro- or minimally invasive glaucoma surgeries (MIGS) have been the latest addition to the glaucoma surgical treatment paradigm. This term refers not to a single surgery, but rather to a group of distinct procedures and devices that aim to decrease intraocular pressure. Broadly, MIGS can be categorized into surgeries that increase the trabecular outflow [Trabectome, iStent (first and second generations), Hydrus microstent, Kahook Dual Blade and gonioscopy-assisted transluminal trabeculotomy], surgeries that increase suprachoroidal outflow (Cypass microstent and iStent Supra), and conjunctival bleb-forming procedures (Xen gel stent and InnFocus microshunt). Compared to traditional glaucoma surgeries, such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves), MIGS are touted to have less severe complications and shorter surgical time. MIGS represent an evolving field, and the efficacy and complications of each procedure should be considered independently, giving more importance to high-quality and longer-term studies.
References
Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study
Prospective, unmasked evaluation of the iStent® inject system for open-angle glaucoma: synergy trial
Dislocation of a previously successful XEN glaucoma implant into the anterior chamber: a case report
Efficacy of Goniotomy With Kahook Dual Blade in Patients With Uveitis-associated Ocular Hypertension
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