A summary on recent advances in MIGS, both on ab interno and ab externo approaches, with a focus on state of play in product development and clinical trial data.

What’s New:

Update on MIGS

Author: Robert Stamper MD, PhD

Department of Ophthalmology, University of California in San Francisco, USA

Core concepts

• Newer techniques are evolving with the promise of less risk of vision-threatening complications.
• Most need more study before being placed in our range of antiglaucoma surgical strategies.
• A summary of current knowledge is provided in table 1.
• Possible utilization of various MIGS procedures based on glaucoma severity is proposed in Table 2 – based on current knowledge; subject to change as more information and experience become available.
• While no comparative studies are available yet, possibly some of these newer procedures will allow us to consider surgical treatment earlier in the glaucoma treatment paradigm. Safety and predictable effectiveness will determine this.
• Enhanced interest in better surgical approaches to glaucoma portends exciting times ahead.