MIGS Offers More Options to Glaucoma Patients

Minimally Invasive Glaucoma Surgery (MIGS) is a tremendous advancement in glaucoma care. Prior to MIGS, treatment options were limited to medications, lasers, and major tube and trabeculotomy surgeries. Now, with MIGS, the surgical team at Vance Thompson Vision has more treatments to draw from and patients benefit from shorter recovery times, a higher safety profile, and less dependence on medications post-surgery.

MIGS is usually performed at the same time as cataract surgery in patients with mild to moderate glaucoma. Several different surgical devices and techniques fall under the MIGS umbrella. All are designed to increase fluid drainage from the eye and to decrease intraocular pressure.


The iStent is the smallest medical device ever implanted into humans. The iStent decreases eye pressure by creating a pathway in the high-resistance portion of the eye’s drainage system. The iStent was the first trabecular micro-bypass device approved by the FDA and is the most thoroughly-studied glaucoma device on the market. By creating a pathway through the eye, the iStent helps fluid drain naturally.

Kahook Dual Blade

The Kahook Dual Blade is a single-use blade that a surgeon uses to gently remove a section of the trabecular meshwork, increasing drainage in the eye. For this procedure, the surgeon makes a small incision in the cornea and inflates the inside of the eye so the Kahook Dual Blade can be inserted. The tool is used to remove a section of the trabecular meshwork at the base of the cornea.

Ab Interno Viscocanalaplasty and Trabeculotomy (OMNI)

In the OMNI procedure, the surgeon inserts a microcatheter into the eye through a tiny incision and then rotates the tool to open up the entry point. The surgeon then injects gel into the canal, which enlarges the drainage area. Then, a piece of the trabecular meshwork, the most common site of resistance in the eye, is removed.

ECP Laser Treatment

Endoscopic cyclophotocoagulation (ECP) decreases the amount of fluid produced by the eye. During the procedure, a probe is inserted into the eye through the same incision made during cataract surgery. The surgeon then applies laser energy to the ciliary body epithelium, which controls the production of fluid in the eye. The laser energy causes inflammation and scarring of the ciliary epithelium, thus decreasing the amount of fluid it produces.

XEN Gel Stent

The XEN Gel Stent is a soft, gelatin tube inserted into the eye to increase drainage from the eye. The stent is about as wide as a human hair and is 6 mm long. The surgeon inserts the device through a small, self-healing incision in the cornea. The stent creates a new pathway so fluid can drain from the front area of the eye to the area just under the eyeball’s surface. The stent softens and becomes a flexible pathway for fluid to drain.

Invested in Glaucoma Care

The Vance Thompson Vision team is nationally recognized for glaucoma research and surgery, authoring numerous book chapters and scientific articles in addition to lecturing nationally and internationally. We are committed to using the world’s most advanced technology and techniques to halt glaucoma progression so you can live a life full of sight. To set up an appointment or to ask questions, please contact us today.