Treatment for Glaucoma

MIGS (Minimally Invasive Glaucoma Surgery)

Small-incision surgical options that lower eye pressure with faster recovery

When to seek immediate care

  • •Sudden severe eye pain or headache
  • •Sudden decrease in vision
  • •Increasing redness, discharge, or swelling
  • •Seeing flashes of light or new floaters

Contact your surgeon immediately or seek emergency care if you experience any of these symptoms after surgery.

MIGS refers to a group of surgical procedures that lower eye pressure through tiny incisions with minimal trauma to the eye. These procedures are generally safer than traditional glaucoma surgery and allow for faster recovery. MIGS is often performed during cataract surgery but can also be done as a standalone procedure. While the pressure reduction may be more modest than traditional surgery, MIGS can help many patients reduce their dependence on eye drops.

How it works

MIGS procedures work by improving the eye's natural drainage pathways or creating new ones. There are several types: some devices (like iStent or Hydrus) create a bypass through the trabecular meshwork; others (like Xen or PRESERFLO) create a new drainage channel under the conjunctiva; and some procedures (like goniotomy) remove tissue that's blocking drainage.

What makes MIGS 'minimally invasive' is that these procedures use tiny incisions, often through the same opening used for cataract surgery, and don't require creating a large filtration bleb like traditional trabeculectomy. This generally means less risk of serious complications and faster visual recovery.

Animation showing different MIGS devices improving fluid drainage in the eye

Is this right for me?

This may be considered if you have:

  • Mild to moderate open-angle glaucoma
  • Eye pressure that's not well controlled with drops or laser
  • Difficulty tolerating or remembering multiple daily eye drops
  • Planning cataract surgery (MIGS can be combined)
  • Looking for a lower-risk surgical option than traditional glaucoma surgery

It may not be a good fit if you have:

  • Advanced glaucoma requiring maximum pressure reduction
  • Angle-closure glaucoma (some MIGS procedures require open angles)
  • Previous eye surgeries that have altered the drainage anatomy
  • Need for very low target pressures that only traditional surgery can achieve

Your glaucoma specialist can help determine which MIGS procedure, if any, is appropriate for your type and severity of glaucoma.

What to expect

1

Before

  • •Comprehensive eye exam to assess your glaucoma and surgical options
  • •Discussion of which MIGS procedure is best for your situation
  • •Instructions about medications and eating before surgery
  • •Arrange for someone to drive you home after the procedure
2

During

MIGS is usually performed in an outpatient surgery center under local anesthesia with sedation. The procedure typically takes 15-30 minutes. When combined with cataract surgery, the MIGS component adds only a few minutes. You may be aware of light and movement but shouldn't feel pain.

3

After

  • •Most patients go home the same day
  • •Vision may be blurry initially as the eye heals
  • •Eye drops are prescribed to prevent infection and inflammation
  • •Activity restrictions vary by procedure — your doctor will provide guidance
  • •Several follow-up visits are needed to monitor healing and pressure
While MIGS is considered safer than traditional glaucoma surgery, all surgical procedures carry risks including infection, bleeding, inflammation, and failure to adequately control pressure. Discuss the specific risks of your recommended procedure with your surgeon.

Frequently asked questions

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Sources

Information on this page is based on the following authoritative sources:

Last updated: April 2026