A gentler way to lower eye pressure and protect your vision in Las Vegas and Henderson Nevada.
Minimally invasive glaucoma surgery is a modern group of procedures that use tiny instruments and microscopic openings to help lower eye pressure with less disruption to the eye than traditional glaucoma surgery. For many people with mild to moderate glaucoma, MIGS can bridge the gap between drops or laser and more invasive procedures, offering a safer way to manage pressure while you stay active and independent.
At Wellish Abrams Vision Institute, our glaucoma specialists use minimally invasive glaucoma surgery as part of an “interventional glaucoma” approach. Instead of waiting for severe damage, we aim to intervene earlier, personalize your treatment plan, and protect your optic nerve for the long term.
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What is Minimally Invasive Glaucoma Surgery (MIGS)?
Minimally invasive glaucoma surgery, often shortened to MIGS, is not a single operation. It is a family of techniques that share three core features: tiny instruments, tiny incisions, and a focus on safer, faster recovery compared to older glaucoma surgeries.
In glaucoma, pressure inside the eye often rises because the natural drainage system does not move fluid out efficiently. MIGS procedures either help that fluid leave the eye more easily or gently reduce the amount of fluid the eye produces. Unlike traditional trabeculectomy or tube shunt surgeries, many MIGS procedures avoid creating an ample drainage “bleb” on the eye’s surface, which helps preserve tissue for future options if you ever need stronger surgery.
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MIGS procedures are designed to improve the eye’s natural drainage system so fluid can flow out more easily, and eye pressure can be lowered. When this drainage pathway becomes blocked or less efficient, pressure builds up and can damage the optic nerve. Using tiny instruments or microscopic stents, MIGS gently opens, improves, or bypasses the eye’s existing drainage channels to restore healthier fluid flow. In some cases, a small new drainage pathway is created in a controlled way to help reduce pressure. The goal is to lower eye pressure effectively with less disruption and a faster recovery than traditional glaucoma surgery.
MIGS is often performed at the same time as cataract surgery. During one visit to the operating room, your surgeon can remove the cloudy lens that blurs your vision and, at the same time, place a MIGS device or perform a MIGS procedure to address pressure.
MIGS is typically recommended for adults with mild to moderate open-angle glaucoma who need better eye pressure (IOP) control than drops or laser treatment alone can provide.
You may be a good candidate for MIGS if you:
Have glaucoma that is progressing
Have an intraocular pressure above your target range
Struggle to tolerate or consistently use glaucoma drops
Are already planning cataract surgery and want to treat glaucoma at the same time
Those with advanced glaucoma, rapidly worsening disease, or certain types such as angle-closure or secondary glaucoma may require more traditional glaucoma surgery to reach lower target pressures safely.
What to Expect Before, During, and After MIGS
Your experience with minimally invasive glaucoma surgery follows a clear path, from preparation to recovery, so you know what to expect at every stage.
1
Before Surgery
You will have a detailed glaucoma evaluation. Your doctor measures eye pressure, examines the front and back of the eye, and may use advanced imaging to look closely at the optic nerve and drainage structures. Corneal thickness and your response to current medications are reviewed, and your surgeon explains which MIGS technique is recommended and why.
2
During Surgery
You are cared for in an outpatient surgery center. You receive numbing drops and light anesthesia so you stay comfortable but are typically awake. Using a microscope and delicate instruments, your surgeon performs the planned MIGS procedure through tiny incisions inside the eye. If you are also having cataract surgery, both methods are usually completed in the same session, often within an hour for most patients.
3
After Surgery
You go home the same day with a protective shield over the eye. Prescription drops help control inflammation and prevent infection. It is normal to notice mild irritation, light sensitivity, or blurred vision at first. These symptoms usually improve over the first days to weeks, while pressure changes can continue to fine-tune over several months as the eye heals and the MIGS device or procedure reaches its full effect.
4
Follow-up visits
At Wellish Abrams Vision Institute allow your doctor to monitor eye pressure, check the surgical site, and adjust drops or other treatments as needed during comprehensive eye exams.
Benefits and Limitations of MIGS
For the right patient, minimally invasive glaucoma surgery can offer a meaningful balance of safety and effectiveness. The smaller incisions and less invasive approach tend to lower the risk of some serious complications compared to traditional glaucoma surgery, and recovery is often smoother and more comfortable.
Many patients can reduce their dependence on glaucoma drops after a successful MIGS procedure, which can make daily life easier and limit side effects. Because MIGS preserves much of the eye’s surface tissue, it usually keeps future surgical options open if you ever need additional help controlling pressure.
It is important to understand that MIGS does not cure glaucoma. The goal is to bring eye pressure into a safer range and slow or stop further optic nerve damage. You will still need routine glaucoma monitoring and may still need some medication, even with a well-healed MIGS procedure.
Advanced Glaucoma Surgery Options & Patient Resources
iDose® TR
Implant that delivers glaucoma medication, reducing daily drops.
In some people, MIGS significantly reduces or even eliminates the need for drops. In others, it allows for fewer medications or lower doses. Your exact plan depends on how your eye responds and what pressure level your doctor wants to maintain.
For many patients with mild to moderate disease, MIGS offers a lower risk of serious complications and a more comfortable recovery because the procedures are less invasive. However, when very low eye pressures are needed, more traditional surgeries may still be recommended.
In many cases, yes. Some MIGS techniques are designed to pair with cataract surgery, while others can be done on eyes that already have an artificial lens. Your surgeon will recommend options based on your anatomy and prior procedures.
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Discover if minimally invasive glaucoma surgery, laser therapy, or a customized treatment plan is right for you. Protect your vision for the years ahead.
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