Minimally Invasive Glaucoma Surgery: A Critical Appraisal of the Literature.
AI Summary
This review critically appraised various minimally invasive glaucoma surgeries (MIGS). Key finding: MIGS offer diverse, generally safer options for lowering eye pressure than traditional surgeries, but efficacy varies and requires independent, long-term study.
Abstract
Micro- or minimally invasive glaucoma surgeries (MIGS) have been the latest addition to the glaucoma surgical treatment paradigm. This term refers not to a single surgery, but rather to a group of distinct procedures and devices that aim to decrease intraocular pressure. Broadly, MIGS can be categorized into surgeries that increase the trabecular outflow [Trabectome, iStent (first and second generations), Hydrus microstent, Kahook Dual Blade and gonioscopy-assisted transluminal trabeculotomy], surgeries that increase suprachoroidal outflow (Cypass microstent and iStent Supra), and conjunctival bleb-forming procedures (Xen gel stent and InnFocus microshunt). Compared to traditional glaucoma surgeries, such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves), MIGS are touted to have less severe complications and shorter surgical time. MIGS represent an evolving field, and the efficacy and complications of each procedure should be considered independently, giving more importance to high-quality and longer-term studies.
MeSH Terms
Shields Classification
Key Concepts6
Compared to traditional glaucoma surgeries such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves), MIGS are reported to have less severe complications and shorter surgical time.
Micro- or minimally invasive glaucoma surgeries (MIGS) are a group of distinct procedures and devices that aim to decrease intraocular pressure.
MIGS can be categorized into surgeries that increase trabecular outflow, including Trabectome, iStent (first and second generations), Hydrus microstent, Kahook Dual Blade, and gonioscopy-assisted transluminal trabeculotomy.
MIGS can be categorized into surgeries that increase suprachoroidal outflow, including Cypass microstent and iStent Supra.
MIGS can be categorized into conjunctival bleb-forming procedures, including Xen gel stent and InnFocus microshunt.
The efficacy and complications of each minimally invasive glaucoma surgery (MIGS) procedure should be considered independently, with emphasis on high-quality and longer-term studies.
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