Minimally Invasive Glaucoma Surgery (MIGS) is the use of small implants to improve the drainage of aqueous humour and lower eye pressure while limiting disruption to surrounding eye structures. We will assess your overall eye condition to determine the most appropriate MIGS procedure and tailor the surgical plan to your eye.
Glaucoma is a condition that causes progressive damage to the optic nerve, often associated with increased pressure inside the eye. In many cases, glaucoma develops without noticeable symptoms, which is why regular eye examinations are important for early detection. Some patients experience mild eye discomfort or a sensation of pressure around the eyes, while more advanced disease can lead to gradual peripheral vision loss.
Acute glaucoma presents differently and causes a sudden rise in eye pressure, requiring urgent and immediate treatment. Symptoms include:
Learn more about glaucoma, including its types and causes here.
Minimally invasive glaucoma surgery (MIGS) lowers eye pressure by improving the drainage of aqueous humour through the eye’s natural drainage system. The iStent® consists of tiny implants placed through the trabecular meshwork to create bypass channels into Schlemm’s canal. The Hydrus® Microstent is placed within Schlemm’s canal, where it bypasses the trabecular meshwork and holds part of the canal open to improve access to the surrounding drainage channels. By reducing resistance to fluid outflow, these implants help lower eye pressure and can reduce the need for glaucoma eye drops.
The procedure is performed through a very small incision in the cornea under local anaesthesia and is commonly combined with cataract surgery. A specialised viewing lens is used to visualise the drainage angle while the implant is positioned within the eye’s drainage system. The MIGS portion of the procedure generally takes around 10 to 15 minutes, and you can usually return home on the same day.
After surgery, the eye can feel mildly irritated and vision can be temporarily blurred or sensitive to light while the eye settles. Eye drops are prescribed during the recovery period to control inflammation and support healing. Follow-up appointments are arranged to monitor the eye pressure, check the position of the implant and assess the response to treatment.
From your initial consultation to treatment and follow-up care, our team will guide you through every stage of your journey. We will take the time to explain your condition, answer your questions and help you feel informed and supported throughout your care.
Your consultation begins with a detailed assessment of your vision and eye health. Depending on your condition, this may include measurements of your vision and eye pressure, examination of the front and back of the eye, and advanced diagnostic imaging.
Our team will guide you through each test and explain what is being assessed. Your results will then be carefully reviewed to understand your individual needs and determine whether monitoring or treatment may be recommended.
Every eye and every patient is different. Your treatment plan will be tailored according to your examination findings, visual needs, general health and lifestyle.
We will explain the recommended treatment, its expected benefits, possible risks and any suitable alternatives in a clear and straightforward manner. You will have time to ask questions and consider your options before deciding how you would like to proceed.
Before your treatment, our team will guide you through the necessary preparations, paperwork and medication instructions. Where applicable, we will explain how to use your prescribed eye drops and how to care for your eyes afterwards.
We understand that undergoing a procedure can feel unfamiliar or worrying. Our team will be available to answer your questions and ensure that you know what to expect before the day of your treatment.
On the day of your procedure, you will arrive at the hospital or surgical centre where your operation has been scheduled. The surgical team will help you prepare and explain what will happen at each stage.
Anaesthetic eye drops or other forms of anaesthesia may be used, depending on the procedure, to keep you comfortable. Your doctor and the surgical team will support and reassure you throughout the operation.
Most eye surgeries are performed as day procedures, although the duration and recovery process will depend on the treatment you receive. Your vision may be temporarily blurred afterwards, so you should arrange for someone to accompany you home and should not drive unless your doctor has advised that it is safe to do so.
We will provide clear instructions on how to care for your eyes, use any prescribed medication and manage your activities during recovery. We will also explain which symptoms are expected and when you should contact the clinic for further advice.
Follow-up appointments allow us to monitor your vision, assess your recovery and identify any concerns at an early stage. Our team remains accessible should you have any questions or concerns throughout your recovery.
Glaucoma treatment is not one-size-fits-all. At Ascend Eye Clinic, we assess your eye pressure, drainage angle, stage of glaucoma and current medications to determine whether MIGS with the iStent® or Hydrus® Microstent is suitable for you.
Book a consultation to explore a personalised treatment plan for protecting your vision and achieving better long-term eye-pressure control.
MIGS is used to lower eye pressure and reduce the risk of further glaucoma damage. We recommend it when additional pressure control is needed and when a less invasive surgical approach is suitable for the eye.
MIGS uses smaller surgical approaches than traditional glaucoma surgery and is designed to lower eye pressure with less disruption to the surrounding tissues. It is still an eye operation and requires appropriate preparation, follow-up and postoperative care.
Anaesthesia is used to keep the eye comfortable during surgery. Mild soreness, irritation or a gritty sensation can occur afterwards, but this settles as the eye heals.
Yes. MIGS is generally performed under local anaesthesia with sedation, so you remain awake but relaxed and comfortable throughout the procedure.
The procedure is relatively short, although the exact duration depends on the surgical technique used and whether MIGS is performed together with another eye procedure.
MIGS is generally performed as day surgery. You will be monitored for a period after the procedure before returning home.
Vision is often blurred temporarily after MIGS because of inflammation, eye drops and the healing process. It gradually clears as the eye settles.
The eye generally recovers over the following days to weeks. Most light daily activities can be resumed relatively early, while strenuous exercise, swimming and heavy lifting require a longer break.
The main purpose of MIGS is to lower eye pressure and protect the optic nerve. It does not restore vision that has already been lost from glaucoma.
This depends on the pressure achieved after surgery. Some patients require fewer eye drops afterwards, while others continue using medication to keep the pressure at the required level.
We monitor your eye pressure closely after surgery and continue checking the optic nerve and visual field over time. This allows us to assess whether the pressure has reached a level that provides adequate protection for the optic nerve.
Avoid rubbing the eye, swimming, strenuous exercise and heavy lifting during the early recovery period. Keep water, dust and other contaminants away from the eye while it heals, and follow the eye drop schedule we provide.
Risks include inflammation, bleeding inside the eye, temporary changes in eye pressure, infection and the need for additional glaucoma treatment. We will explain the risks relevant to your planned procedure before surgery.
Yes. Eye pressure can change over time as the eye heals or the glaucoma progresses. Regular follow-up allows us to detect these changes and adjust treatment when needed.
Yes. Glaucoma requires ongoing monitoring even when the eye pressure is well controlled after surgery. We continue checking the pressure, optic nerve and visual field to make sure the condition remains stable.
