MIGS (Minimally Invasive Glaucoma Surgery) includes a range of modern, low-risk procedures that lower eye pressure and prevent glaucoma progression. Learn how MIGS works, who it suits, and what to expect from treatment.
MIGS, or Minimally Invasive Glaucoma Surgery, is a group of advanced, small-incision procedures designed to reduce intraocular pressure (IOP) in patients with open-angle glaucoma.
Unlike traditional glaucoma surgery, MIGS techniques use micro-devices and micro-stents to enhance the eye’s natural drainage with minimal tissue disruption, quicker recovery, and an excellent safety profile.
MIGS can be performed as a standalone procedure or combined with cataract surgery.
Common MIGS devices and techniques include:
Hydrus Microstent
iStent inject®
OMNI Canaloplasty / Trabeculotomy
Preserflo MicroShunt (slightly more invasive but still low-risk)
MIGS is an ideal option for patients who need more pressure control than eye drops can provide, without the risks of major glaucoma surgery.
Different MIGS devices work through one of three mechanisms:
Procedures like iStent or Hydrus improve flow through the trabecular meshwork — the eye’s primary drainage channel.
These micro-stents create a direct route for fluid to leave the eye more easily.
These treatments clean, widen or unblock Schlemm’s canal to improve long-term drainage.
All MIGS procedures use:
Micro-incisions
Ultrafine devices
Minimal tissue disruption
This results in a high safety margin, rapid healing, and effective long-term pressure lowering.
Lowers eye pressure safely
Reduces dependence on glaucoma drops
Slows or halts glaucoma progression
Quick recovery with minimal discomfort
Low complication rate
Safe to combine with cataract surgery
Suitable for earlier intervention
Targets drainage directly for more predictable outcomes
MIGS bridges the gap between eye drops and major glaucoma operations like trabeculectomy.
MIGS may be recommended if you have:
Open-Angle Glaucoma (mild to moderate stages)
Ocular Hypertension (OHT) needing better pressure control
Difficulty tolerating glaucoma drops
Progression despite medication
Cataracts + glaucoma, where combined surgery offers dual benefit
A desire to reduce long-term reliance on medication
MIGS is not typically used for angle-closure glaucoma, severe glaucoma, or eyes with advanced optic-nerve damage requiring very low pressure targets.
Performed under local anaesthetic (with or without sedation)
Often combined with cataract surgery through the same incision
MIGS devices are implanted through microscopic instruments
Most procedures take 10–20 minutes
You go home the same day
Mild irritation or blurring is common for 24–48 hours
Normal activities resume quickly
Follow-up appointments check pressure, stent position, and healing.
Early MIGS intervention may be beneficial if:
Pressure is fluctuating or inadequately controlled
You cannot tolerate drops due to irritation or allergies
You want long-term reduction in medication burden
You have early to moderate glaucoma and are undergoing cataract surgery
Pressure control is needed before significant nerve damage occurs
Early MIGS can slow disease progression and preserve long-term vision.
Mild discomfort or redness settles within a few days
Use prescribed drops for 4–6 weeks
Avoid heavy lifting and eye rubbing
Vision improves steadily after initial blurring
Pressure stabilises over the following weeks
You can usually return to normal routines quickly
Most MIGS devices remain permanently in place and continue to lower pressure long term.
