Minimally Invasive Glaucoma Surgeries (MIGS)
Understanding Glaucoma
Glaucoma is a group of eye diseases that can damage the optic nerve, most often due to increased pressure inside the eye. This condition can develop slowly and quietly, making early detection and proper management essential to prevent permanent vision loss.
This is the most common form of glaucoma, often developing gradually because the eye’s drainage system becomes less effective. Many people notice no symptoms until they begin to lose vision, which is why routine eye exams are vital.
This less frequent but more severe type happens suddenly when the drainage angle of the eye becomes blocked. Symptoms like sudden eye pain, headache, and blurred vision require immediate medical attention as they can lead to rapid vision loss.
Some cases are caused by other medical conditions, injuries, or medications. Knowing the underlying cause helps your doctor create a tailored treatment plan for your particular needs.
Glaucoma risk increases with age, family history, African American or Hispanic heritage, nearsightedness, and certain health problems like diabetes and high blood pressure. Our eye doctors in North Wales check for these risks so you can take action early.
In the early stages, glaucoma may not cause any noticeable symptoms. As it advances, you might notice blind spots in your side vision or halos around lights. Quick attention to vision changes or eye pain is important for your eye health.
Symptoms of glaucoma can look like those from conditions such as cataracts or macular degeneration. A comprehensive eye exam at ReFocus Eye Health North Wales helps ensure you get the proper diagnosis and treatment.
What Are MIGS Procedures?
MIGS stands for Minimally Invasive Glaucoma Surgeries. These procedures use tiny instruments to improve the eye’s drainage and lower pressure with less risk and discomfort than traditional surgeries. They are a modern choice for many patients in the Greater Philadelphia Region and surrounding areas.
Your eyes produce a clear fluid that nourishes the tissues. When this fluid can’t drain properly, pressure builds up and can harm your optic nerve. MIGS improves drainage by using surgical techniques that are less invasive and promote safety.
Standard glaucoma surgeries, like trabeculectomy, involve larger cuts and longer healing. MIGS uses smaller incisions and microscopic tools, allowing for a faster recovery and lower risk of complications.
MIGS is often performed at the same time as cataract surgery, providing convenience and effectiveness. Clinical research shows MIGS can successfully lower pressure and reduce the need for daily medications, especially in mild to moderate cases.
Most people experience only minor discomfort, clear vision returns quickly, and returning to normal activities is much faster with MIGS. Many patients value fewer daily eye drops and a smoother healing process.
Types of MIGS We Offer
There are several MIGS options available at ReFocus Eye Health North Wales. Our eye doctors recommend the best choice based on your unique situation and the structure of your eye.
The iStent Inject uses two tiny stents implanted in the eye’s natural drainage system to help fluid leave the eye. This is usually done alongside cataract surgery and can reduce your reliance on glaucoma medicines.
This device is designed to open a wider section of the drainage canal, offering greater fluid flow and is especially effective for mild to moderate open-angle glaucoma.
Made from soft gel, the Xen Gel Stent creates a new drainage path from inside the eye to under the surface tissue. It is often chosen for moderate to advanced glaucoma or situations where other options haven’t worked.
This procedure uses a special probe to remove a tiny piece of blocked tissue, restoring natural drainage without the need for an implant. It is often used for primary open-angle glaucoma.
The Kahook Dual Blade makes precise, gentle cuts to the drainage tissue, removing blockages and reducing the risk of scarring. It can be used on its own or with cataract surgery.
This laser treatment gently decreases fluid production by treating a part of the eye called the ciliary body. It can be safely combined with cataract surgery for added effect.
Weighing the Benefits and Risks
MIGS procedures offer many advantages, but like all surgeries, they also carry some risks. Knowing both helps you make the best decision for your eye health.
Many patients find they use fewer eye drops or sometimes can stop them altogether after MIGS. This can be a relief for those who experience side effects from medications.
Most people recover quickly from MIGS, often going back to their normal activities within a week. Your eye doctor will share guidance for your specific case.
By using smaller instruments and less invasive techniques, MIGS reduces the chances of complications like serious infections or bleeding, making healing easier for most patients.
Because MIGS doesn’t remove large portions of tissue, you still have the possibility of undergoing traditional surgery or additional treatments in the future if necessary.
Possible complications include short-term inflammation, pressure spikes, or minor bleeding. Severe problems are rare, but your doctor will discuss your personal risk profile before you decide on surgery.
Who Are Good Candidates for MIGS?
MIGS may be right for you if you have mild to moderate open-angle glaucoma that isn’t well controlled with medications. Our team will help you decide based on your needs and overall health.
Good candidates often have early glaucoma damage, trouble with medication schedules, or side effects from drops. MIGS can also fit those who want to reduce their reliance on medications.
Your eye doctor will review your health history and carry out detailed tests, including vision and drainage examinations, to find the MIGS procedure that’s right for you.
MIGS is a good match for patients who want to return to their routines quickly. Commitment to follow-up care helps make treatment as successful as possible.
For some patients, such as those with advanced glaucoma or significant scarring, traditional surgery may offer more effective pressure control than MIGS. Your doctor will go over all your options in detail.
MIGS aims to manage glaucoma, not cure it. Staying in close touch with your eye care team and asking questions along the way is the best way to get results that protect your vision.
What to Expect: Before, During, and After MIGS
Knowing what will happen from start to finish helps you feel prepared and confident about your procedure. Our goal at ReFocus Eye Health North Wales is to make every step as smooth as possible for you.
Your doctor will run specific tests, explain the procedure, and discuss any medication adjustments before your surgery. You will need someone you trust to drive you home after the procedure.
MIGS is usually performed under local anesthesia on an outpatient basis. The procedure usually takes between 15 and 45 minutes, depending on the type and whether combined with cataract surgery.
Expect mild discomfort, some blurriness, and sensitivity to light for the first few days. Recovery instructions and medication will be clearly explained to help prevent complications and support healing.
To ensure proper healing, follow your doctor’s instructions:
- Use prescribed eye drops exactly as directed.
- Avoid touching or rubbing your eye.
- Wear a protective shield at night if advised.
- Avoid swimming and strenuous exercise until you are cleared.
- Attend all follow-up visits.
- Contact your doctor if you have severe discomfort, vision loss, or signs of infection.
Even after successful MIGS, glaucoma requires regular monitoring. Our eye doctors offer lifelong support to help keep your vision healthy for years to come.
Frequently Asked Questions
Many patients in North Wales and nearby communities have questions about MIGS. Here are answers to some of the most common concerns. If you have other questions, our team at ReFocus Eye Health North Wales is always here to help.
No, MIGS is designed to be comfortable. You’ll be given numbing medicine, so you might feel some pressure but should not feel pain during the procedure. Mild soreness is common afterward, and over-the-counter pain relief is usually all you need.
Most people feel better and return to normal activities within a week. Complete healing can take four to six weeks, and your doctor will advise you on any specific precautions or limitations.
No, MIGS manages glaucoma by lowering eye pressure and helping keep it under control. It does not reverse vision loss or cure glaucoma. Ongoing care remains important.
Yes. Options include prescription eye drops, oral medication, laser treatment, and more traditional surgeries such as trabeculectomy. The best approach is personalized to your unique needs.
MIGS provides reliable long-term pressure control for many patients, especially if eye drops alone are not enough or cause side effects. For some, it can lead to fewer medications and more stable eye pressure.
Yes, because MIGS procedures are less invasive, it is often possible to repeat them or try other options in the future, depending on your eye health and pressure control.
MIGS is considered very safe and is frequently performed on adults over 65. The gentle approach and quick recovery often make it a good choice for older patients.
Absolutely. Follow-up visits stay important for checking your eye health and pressure. Our team tracks your progress to keep your vision safe over time.
Healthy habits like regular exercise, a balanced diet, and careful control of diabetes or high blood pressure help support your eye health after surgery.
No, combining MIGS with cataract surgery is safe and often provides excellent results for both conditions, making it a convenient option for many.
Most patients are ready to drive within a few days to a week, but this depends on your recovery and how your vision improves. Your doctor will let you know when it’s safe for you.
Most insurance plans, including Medicare, cover MIGS if they are medically necessary. It’s a good idea to check your own coverage to know what to expect.
If your eye pressure remains too high, you may return to eye drops, undergo additional procedures, or consider traditional surgery. Your eye doctor will discuss the safest and most effective plan for you.
Your Vision, Our Commitment
Your eye health is our top priority at ReFocus Eye Health North Wales. Whether you live nearby or in the Greater Philadelphia Region, our experts are ready to help you explore the latest glaucoma treatments and find the best path to preserve your sight. We look forward to guiding you every step of the way.
Dr. Barouh is thorough, engaged with every patient’s health, and thoroughly discusses her program for my vision and eye health.
Bob Gordon
Dr. Lindsey Barouh is extremely courteous and professional. Did not have to wait long at all. Thank you.
Maria Varki
Linda and Dr. Barouh were great—she removed object causing pain, provided details. Listening to them made the visit easier.
Bill Keen
Such a welcoming practice. Dr. Clark is the most empathic doctor—a great communicator.
Carol Harrison
Dr. Lindsey Barouh is the best. Very thorough exam. She explains your eye health. A wonderful doctor. I hope to see her for years more.
Elaine Fader
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Wednesday: 8am-4pm
Thursday: 8am-4pm
Friday: 8am-4pm
Saturday: Closed
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