Minimally invasive glaucoma surgery: current implants and future innovations

Traditionally, invasive surgical management of glaucoma is recommended when medication and/or laser trabeculoplasty fail to control intraocular pressure (IOP). Filtering procedures, such as trabeculectomy and glaucoma drainage devices, are effective in lowering IOP, but they have significant associated adverse events and rates of failure. For these reasons, a new group of surgical procedures has emerged that seeks to decrease IOP with lower associated rates of complications. The acronym MIGS, usually described as minimally invasive glaucoma surgery, has been coined to describe this group of procedures. As new devices become available, MIGS procedures will help to fill the gap between conservative medical and laser therapy and invasive surgical treatment of glaucoma to offer patients an earlier and safer transition to surgical management of their disease. In this review, we define the characteristics of an ideal MIGS procedure and discuss implants currently in use or under investigation.