If you’ve been diagnosed with glaucoma, the treatment options can feel overwhelming. You want to protect your vision, but you’re also looking for a procedure that fits your specific needs.

The good news is that advances in minimally invasive glaucoma surgery (MIGS) have given patients more choices than ever before. Each MIGS procedure offers unique benefits, and finding the right one depends on your individual situation.

Keep reading to learn about the four MIGS options available at Focal Point Vision, and discover which approach might be the best fit for managing your glaucoma.

What is MIGS?

MIGS stands for minimally invasive glaucoma surgery, a category of procedures designed to lower intraocular pressure (IOP) and protect your optic nerve from damage. Unlike traditional glaucoma surgeries that require longer recovery times and carry higher risks of complications, MIGS procedures use tiny incisions and advanced techniques to achieve results with less trauma to your eye.

Most MIGS treatments take only 10 to 30 minutes and are performed as outpatient procedures, meaning you can go home the same day. The goal of all MIGS procedures is to improve the drainage of fluid from your eye, which reduces the pressure that can damage your optic nerve over time.

Your MIGS Options at Focal Point Vision

At Focal Point Vision, ophthalmologists Dr. Kenneth Maverick, Dr. Josh Iltis, and Dr. James Lehmann offer four different MIGS options:

ExPRESS Shunt

The ExPRESS Shunt is a medical-grade stainless steel device about the size of a grain of rice. During the procedure, your ophthalmologist creates a small flap in your eye and inserts a shunt to create a channel that drains fluid from your eye, reducing intraocular pressure.

This procedure is particularly effective for patients who haven’t found relief from medicated eye drops and need more intensive treatment to control their glaucoma. The ExPRESS Shunt offers several advantages: it effectively reduces IOP when medications aren’t enough, it can be removed if necessary, and it typically requires fewer follow-up visits than traditional trabeculectomy.

The procedure is fast and virtually pain-free, with anesthetic drops keeping you comfortable throughout. Clinical studies have consistently shown high safety and efficacy ratings for this approach.

iStent

The iStent is the world’s smallest implantable medical device, made from medical-grade titanium with a special heparin coating. This tiny device creates a permanent drainage pathway through your eye’s trabecular meshwork, allowing fluid to flow more naturally and reducing pressure.

The iStent is FDA-approved and particularly well-suited for patients who have both cataracts and open-angle glaucoma. Many patients appreciate that the iStent can be implanted during cataract surgery, addressing both conditions at once.

Clinical research has shown that up to 68% of patients treated with the iStent no longer needed glaucoma medication one year after treatment. The procedure is performed with numbing eye drops and mild sedation to keep you comfortable, and recovery is relatively quick.

You can typically return to work within a week, though you’ll need to use the prescribed eye drops for 4 to 6 weeks as you heal.

Kahook Dual Blade (KDB)

The Kahook Dual Blade goniotomy uses a specially designed surgical blade that performs two functions simultaneously: removing a section of your eye’s trabecular meshwork and enlarging the drainage area. This approach is particularly effective for patients with mild to moderate open-angle or closed-angle glaucoma.

The KDB procedure is known for achieving a more complete removal of tissue that interferes with fluid drainage than competitors, which can lead to better long-term results. The procedure itself is pain-free and takes only 10 to 20 minutes, performed with IV sedation and numbing eye drops to keep you comfortable.

Patients and providers report high satisfaction rates with this treatment, and you’ll be able to go home the same day, though someone will need to drive you. You’ll use antibiotic and steroid eye drops for a few weeks during recovery, and follow-up appointments will help monitor your progress.

OMNI Surgical System

The OMNI device stands out as an implant-free option that delivers the benefits of two procedures in one: viscodilation (inflating the drainage canal) and trabeculectomy (removing tissue that blocks drainage). This makes OMNI particularly versatile, as it can be used at almost all stages of glaucoma and can be performed alongside cataract surgery through the same small incision.

During the procedure, your ophthalmologist inserts the OMNI cannula through a tiny opening and performs both treatments to improve fluid outflow from your eye. Because OMNI doesn’t leave any permanent implant in your eye, some patients prefer this approach.

The procedure is quick, typically taking about 10 minutes, and most patients return to their normal routines within a week. OMNI has been shown to effectively reduce intraocular pressure while minimizing your reliance on daily glaucoma medications.

How to Choose the Right MIGS Procedure

Selecting the best MIGS procedure for your glaucoma requires careful consideration of several factors. If you have mild to moderate open-angle glaucoma, you might be an excellent candidate for the iStent or KDB.

Patients with varying stages may find OMNI’s versatility advantageous, while those who need more intensive treatment might benefit most from the ExPRESS Shunt.

Your other eye conditions also influence the decision. If you have both cataracts and glaucoma, procedures like the iStent or OMNI, which can be performed during cataract surgery, offer the convenience of addressing both issues at once.

Your treatment history also plays a role. Have prescription eye drops effectively controlled your pressure in the past, or have they failed to provide adequate relief? This information helps your ophthalmologist determine which level of intervention you need.

Some patients have strong preferences for an implanted device or an implant-free approach. The iStent and ExPRESS Shunt involve placing a permanent or semi-permanent device in your eye, while OMNI and KDB work by modifying your eye’s existing structures without leaving hardware behind.

There’s no universally “best” choice, only the best choice for your unique situation. During a consultation at Focal Point Vision, your ophthalmologist will carefully evaluate your eye health, discuss your lifestyle needs, and recommend the MIGS procedure most likely to give you the best long-term results.Schedule a consultation at Focal Point Vision in San Antonio, TX, to discuss which MIGS procedure is right for your glaucoma treatment and take an active role in preserving your sight for years to come.

Which MIGS is Right for Treating My Glaucoma?