Glaucoma Microsurgery By William Goldstein on January 29, 2019

MIGS, which stands for Minimally Invasive Glaucoma Surgery is a common procedure that is used for treating patients with glaucoma. However, experts have discovered that combining MIGS along with Minimally Invasive Cataract Surgery or MICS can result in extremely effective outcomes for Primary Open Angle Glaucoma (POAG) patients when the IOP reduction post cataract surgery is not sufficient.

The number of people suffering from glaucoma is increasing year by year. In 2010, as many as 60.5 million people were affected by the disease. The numbers are expected to increase to almost 80 million by 2020, and as much as 74 percent of these patients will have POAG. Currently, cataract is the number one cause of irreversible blindness in the world, while POAG comes second. Studies have shown that the growing incidence of cataract may be a risk for POAG and high intraocular pressure (IOP).

In other words, by performing MIGS and MICS together, cataract, as well as high intraocular pressure, which is experienced by glaucoma patients, can be treated. One example of the tools used for MIGS is seen above, the iStent

What makes MICS unique?

MICS, along with MIGS, was developed as an approach to fight the leading causes of blindness in the world. It was designed in such a way that it would be safer, more efficient and innovative in every way, which has led to quicker recovery and lower rates of surgery-related complications. Overall, these have led to better surgical outcomes.

In this procedure, incisions smaller than 2 mm are used, which makes Micro-Incision Cataract Surgery so different from other more traditional or older techniques of cataract surgery. Today, it can even be performed using an incision of just 1.5 mm or less. Not only does the smaller incision size dramatically improves safety during the surgery, but it also results in reduced trauma for patients even after surgery, making recovery a much quicker and smoother process. This is because there is lesser tissue disruption.

Even though MICS, as the name suggests, is primarily for cataract patients, it is best performed on patients who have other eye diseases other than cataract, such as primary open-angle glaucoma. MICS does not involve the need for excessive surgical manipulation, which results in lower rates of induced inflammation, making it ideal to be performed on patients with both cataract and POAG. The microincisional glaucoma surgery can be done concurrently with cataract surgery to lower pressure and allow better control of glaucoma without the addition of eye drops.

Now, doctors and researchers are working to make MIGS possible only with an incision of 1mm or less so that surgically-induced complications can be minimized even more and recovery, boosted.

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Dr. William S. Goldstein

Laser Eye Care Center

William S. Goldstein, MD, has been practicing laser eye surgery since 1991. He was one of the first doctors to offer advanced eye care in all of Michigan and is a member of several prestigious organizations: 

  • American Board of Ophthalmology
  • American Academy of Ophthalmology
  • American Society of Cataract and Refractive Surgeons

If you are ready to enhance your vision, call our office at (586) 323-2020 or request a consultation online.

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