What MIGS adds
Minimally invasive glaucoma surgery, or MIGS, describes several procedures that can be performed through small incisions to improve fluid drainage or otherwise lower eye pressure. Some are performed during cataract surgery. Their mechanisms, expected pressure effects and risks differ; the word MIGS does not describe one operation.
When a combined plan may fit
For a patient with glaucoma and a symptomatic cataract, the discussion starts with the type and stage of glaucoma, the current pressure, the target pressure, medications and prior operations. A combined procedure may reduce pressure or medication burden for an appropriate patient. Cataract surgery alone can also change pressure, and some eyes need a stronger glaucoma operation than a MIGS procedure is likely to provide.
What it does not promise
No combined procedure guarantees a particular pressure or an end to eye drops. A patient may still need medicines, laser treatment or additional surgery later. Combining operations may introduce risks beyond cataract surgery alone, depending on the chosen technique. The possibility of postoperative pressure spikes or inflammation is part of the discussion.
Questions to ask
Ask which specific procedure is proposed, what pressure goal it is intended to reach, how success will be measured and what the next step would be if pressure remains above target. The answer should account for the optic nerve, not just the convenience of one trip to the operating room.
Related Guides & Sources
- • Companion Guide: Cataract Surgery When You Have Glaucoma
- • Consultation Checklist: Questions I Would Ask Before Cataract Surgery
- • Peer-Reviewed Study: Ward AL, Chen KH, Schmitz JW. Endoscopic cyclophotocoagulation and Kahook Dual Blade trabeculotomy in combination with phacoemulsification (Can J Ophthalmol 2021)
- • American Academy of Ophthalmology (AAO): Minimally Invasive Glaucoma Surgery (MIGS)