Micro-Invasive Glaucoma Surgery
The Future of Glaucoma Surgery Is Micro-Scale.
MIGS represents a revolutionary shift in how we treat glaucoma — offering gentler, safer surgical options with micro-scale devices and incisions, faster recovery times, and an excellent safety profile. For many patients, MIGS can be combined with cataract surgery to address both conditions in a single procedure.
Understanding MIGS
What Is MIGS?
Minimally Invasive Glaucoma Surgery — commonly referred to as MIGS — is a category of micro-scale surgical procedures designed to lower intraocular pressure (IOP) with significantly less tissue disruption than traditional glaucoma surgeries. These procedures use tiny devices and micro-incisions to improve the eye's natural drainage pathways, reducing pressure and helping to protect the optic nerve from further damage.
Unlike conventional filtering surgeries such as trabeculectomy or tube shunt implantation, MIGS procedures are performed through the same small incision used during cataract surgery. They carry a substantially lower risk of complications, require minimal recovery time, and are often combined with cataract surgery to treat both conditions simultaneously — meaning one anesthesia, one operating room visit, and one recovery period.
Your surgeons at Soni Vision Institute have deep expertise in the full spectrum of micro-invasive glaucoma procedures and stay at the forefront of surgical innovation, ensuring you receive the most advanced, evidence-based care available.
The MIGS Advantage
Why Choose MIGS
Micro-Incision Surgery
MIGS procedures are performed through incisions as small as 1 millimeter — the same micro-incision used for cataract surgery. There are no large cuts, no sutures, and no external bleb formation, resulting in significantly less tissue disruption than traditional glaucoma surgery.
Often Combined with Cataract Surgery
Many MIGS procedures are FDA-approved for use during cataract surgery. Combining both procedures into a single session means one trip to the operating room, one anesthesia, and one recovery period — addressing both vision clarity and glaucoma pressure in a single visit.
Faster Recovery
Because MIGS involves minimal tissue disruption, most patients experience a rapid recovery. Many return to normal daily activities within just a few days — far faster than the weeks-long recovery often associated with traditional filtering surgeries like trabeculectomy.
Excellent Safety Profile
MIGS procedures have been shown in clinical studies to have a significantly lower complication rate compared to traditional glaucoma surgeries. The risk of serious adverse events such as hypotony, bleb infection, or vision-threatening complications is substantially reduced.
Is MIGS Right for You?
Ideal Candidates for MIGS
MIGS procedures are most effective for patients with mild-to-moderate open-angle glaucoma who are seeking a safer, less invasive alternative to traditional glaucoma surgery. During your consultation, Your surgeons will evaluate your specific condition and recommend the approach best suited to your needs. You may be an ideal candidate for MIGS if you:
- Have been diagnosed with mild-to-moderate open-angle glaucoma and are looking for a surgical option with a favorable safety profile
- Are undergoing cataract surgery and want to address both conditions in a single procedure, reducing the total number of surgeries needed
- Struggle with eye drop compliance — whether due to difficulty administering drops, side effects, cost, or simply the daily burden of multiple medications
- Want to reduce your medication burden — MIGS can often lower or eliminate the number of glaucoma eye drops required to maintain safe intraocular pressure levels
Not every glaucoma patient is a candidate for MIGS. Patients with advanced or aggressive glaucoma may require more traditional surgical approaches such as trabeculectomy or tube shunt surgery. Your surgeons will guide you through all available options and help you make an informed decision about your care.
Questions
Frequently Asked Questions
Understanding MIGS
What does MIGS stand for?
MIGS stands for Micro-Invasive Glaucoma Surgery. It refers to a group of micro-scale surgical procedures designed to lower intraocular pressure with less tissue disruption, faster recovery, and a better safety profile than traditional glaucoma surgeries like trabeculectomy or tube shunt implantation. MIGS procedures use tiny devices and micro-incisions to improve the eye’s natural drainage system.
What types of MIGS devices are available?
There are several categories of MIGS procedures, including micro-stents (tiny devices placed in the eye’s drainage canal to improve fluid outflow), canaloplasty (a technique that opens and expands the natural drainage channel), goniotomy (removal of tissue blocking the drainage angle), and drug delivery devices (sustained-release implants that deliver glaucoma medication directly inside the eye). Your surgeons will recommend the best option based on your anatomy and glaucoma stage.
How does MIGS compare to traditional glaucoma surgery?
Traditional surgeries like trabeculectomy and tube shunt implantation achieve greater pressure reduction but carry higher risks and require longer recovery. MIGS offers a gentler approach with fewer complications, faster healing, and a strong safety profile — though the pressure-lowering effect may be more modest. MIGS is ideal for mild to moderate glaucoma where a significant but not maximal pressure drop is the goal.
Can MIGS be combined with cataract surgery?
Yes — in fact, many MIGS procedures, including the iStent inject W and Hydrus Microstent, are FDA-approved specifically for use in conjunction with cataract surgery. Combining both procedures into a single session means one anesthesia, one operating room visit, and one recovery period. This approach allows your surgeons to address both your cataract and glaucoma simultaneously, improving visual clarity while lowering eye pressure.
The Procedure
How long does a MIGS procedure take?
Most MIGS procedures take between 5 and 15 minutes to perform. When combined with cataract surgery, the total procedure time is typically under 30 minutes. The surgery is performed under local anesthesia with mild sedation, and most patients describe the experience as comfortable and painless.
Is MIGS painful?
No. MIGS is performed under local anesthesia with mild sedation, and the vast majority of patients describe the experience as comfortable and painless. Because the incisions are microscopic and the procedure works through the eye’s existing anatomy, there is very little tissue disruption.
What happens during a MIGS procedure?
Your surgeons will make a tiny, self-sealing incision — often through the same incision used for cataract surgery. Using a surgical microscope and specialized instruments, a micro-scale device is implanted into the eye’s natural drainage pathway, or laser energy is applied to reduce fluid production. The goal is to create a new outflow channel or enhance an existing one to lower intraocular pressure.
Are there any risks or side effects?
MIGS carries one of the lowest risk profiles of any glaucoma surgery. Temporary side effects may include mild eye redness, slight blurring, or a transient increase or decrease in eye pressure in the first few days. Serious complications are rare. Your surgeons will review your specific risk factors and help you make an informed decision.
Recovery & Results
What is recovery like after MIGS?
Recovery is typically quick. Most patients return to normal daily activities within one to three days. You will use anti-inflammatory eye drops for several weeks after surgery. Some mild eye redness or blurry vision is normal in the first few days but resolves quickly. Follow-up appointments allow your surgeons to monitor your healing and adjust any medications.
Will I still need glaucoma eye drops after MIGS?
Many patients are able to reduce the number of glaucoma medications they use after MIGS, and some patients are able to eliminate eye drops entirely. However, results vary depending on the severity of your glaucoma, the specific MIGS procedure performed, and your individual response. Your surgeons will discuss realistic expectations during your consultation and will continue to monitor your pressure closely after surgery.
How soon will I notice lower eye pressure after MIGS?
Many patients see a measurable reduction in intraocular pressure within the first few weeks after surgery. However, your surgeons will monitor your pressure over several months to assess the full effect and determine whether adjustments to your medication regimen are appropriate.
Can MIGS be repeated if my glaucoma progresses?
In many cases, yes. Because MIGS procedures are minimally invasive and preserve the eye’s natural anatomy, additional procedures — whether another MIGS device or a more traditional surgery — remain viable options if your glaucoma progresses over time.
Candidacy & Cost
Who is a good candidate for MIGS?
MIGS is typically recommended for patients with mild to moderate open-angle glaucoma who are struggling with the burden of daily eye drops, experiencing side effects from medications, or undergoing cataract surgery and want to address their glaucoma at the same time. Your surgeons will evaluate your specific situation during a consultation.
Does insurance cover MIGS?
Most insurance plans, including Medicare, cover MIGS when it is performed in conjunction with cataract surgery. Coverage for standalone MIGS varies by plan and device. Our team will verify your benefits and explain any out-of-pocket costs before scheduling your procedure.
Can I have MIGS if I’ve already had laser treatment for glaucoma?
Yes. MIGS and laser procedures like SLT work through different mechanisms, so having had laser treatment does not disqualify you from MIGS. In fact, many patients benefit from a stepwise approach — starting with laser, then adding MIGS if additional pressure lowering is needed. Your surgeons will review your treatment history and recommend the best path forward.
Content medically reviewed by the physicians of Soni Vision Institute. Last updated April 2026.