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MIGS — Minimally Invasive Glaucoma Surgery in Ahmedabad

Minimally Invasive Glaucoma Surgery (MIGS) represents a significant advance in glaucoma treatment — offering effective pressure reduction with a much safer profile, less tissue disruption, and a faster recovery compared to traditional glaucoma surgery.

MIGS procedures are performed at Puja Eye Hospital, Naranpura, by Dr. Puja Sheth, using the Zeiss surgical microscope in a fully equipped modular ophthalmic operation theatre.

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What Is MIGS?

MIGS is a category of surgical procedures that use microscopic, minimally traumatic approaches to lower intraocular pressure by enhancing the eye’s natural drainage pathways or creating new ones. Unlike traditional glaucoma surgery, MIGS procedures are designed to be quicker, safer, and more predictable — with a significantly lower risk of serious complications.

MIGS devices and techniques work through different mechanisms — some improve outflow through the eye’s natural trabecular meshwork, others create channels through the sclera (the white of the eye), and others reduce the production of aqueous fluid by treating the ciliary body.

MIGS — Minimally Invasive Glaucoma Surgery in Ahmedabad

How Does MIGS Differ from Trabeculectomy?

Traditional trabeculectomy creates an entirely new drainage route through the eye wall and is highly effective but involves a longer recovery, more intensive post-operative care, and a higher risk profile. MIGS procedures work within or close to the eye’s existing anatomy, resulting in:
  • A significantly lower risk of serious complications such as hypotony (dangerously low eye pressure) or infection
  • Faster visual recovery — patients often experience better vision much sooner after MIGS than after trabeculectomy
  • Less intensive post-operative monitoring and fewer follow-up visits required
  • Easier combination with cataract surgery in a single operative session
The trade-off is that MIGS procedures generally achieve a more modest reduction in eye pressure than trabeculectomy. They are therefore most appropriate for mild to moderate glaucoma, rather than advanced glaucoma requiring very low pressure targets.

Who Is a Candidate for MIGS?

MIGS is most appropriate for:

  • Patients with mild to moderate open-angle glaucoma that is inadequately controlled on maximum tolerated medical therapy
  • Patients undergoing cataract surgery who also have glaucoma — MIGS can be performed simultaneously, improving pressure control without a separate procedure
  • Patients who are not tolerating or not able to consistently use their eye drops
  • Patients who prefer a lower-risk surgical option and do not require the more aggressive pressure reduction that trabeculectomy provides
  • Patients with early glaucoma in whom a step-up from drops is needed before committing to more invasive surgery

Not all patients are suitable candidates for every type of MIGS procedure. Dr. Sheth evaluates each patient’s angle anatomy, glaucoma severity, and clinical history to select the most appropriate approach.

MIGS Combined with Cataract Surgery

One of the most significant advantages of MIGS is that most procedures can be performed in combination with phacoemulsification (cataract surgery) through the same small incisions, at the same operative session.

For patients who have both a cataract and glaucoma, this combination approach achieves two goals in a single procedure — improved vision from cataract removal and improved pressure control from the MIGS device — reducing the need for separate surgeries and the cumulative risk that comes with multiple procedures.

What to Expect

MIGS procedures are performed under local anaesthesia, typically taking 15 to 30 minutes as standalone procedures (longer if combined with cataract surgery). The recovery is significantly faster and less demanding than after trabeculectomy. Post-operative eye drops are prescribed, and follow-up visits are arranged to monitor the pressure response.

Puja Eye Hospital- Glaucoma Eye Hospital

  • 918780012121
  • 401-402, The 132 Offices and Showrooms Near Shell Petrol Pump, Besides Indraprastha Saptak 132 Ft. Ring Road, AEC Cross Rd, Naranpura, Ahmedabad, Gujarat 380013
  • Monday to Saturday : 9:30 am–4:30 pm
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Protect Your Vision — Book a Glaucoma Evaluation Today

Call or WhatsApp Dr. Puja Sheth: +91 8780012121 Puja Eye Hospital, Naranpura, Ahmedabad | Mon–Sat: 9:30 AM – 4:30 PM
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FAQs

Is MIGS as effective as trabeculectomy?
MIGS typically achieves a more modest reduction in eye pressure than trabeculectomy. For patients with mild to moderate glaucoma, this level of reduction is often sufficient to stabilise the disease. For patients with advanced glaucoma requiring very low target pressures, trabeculectomy or a tube shunt may be more appropriate. Dr. Sheth will recommend the most suitable procedure based on the severity of your glaucoma and your target eye pressure.
Can MIGS fail?
As with all surgical procedures, MIGS is not always successful. Some patients do not achieve adequate pressure reduction, or the initial benefit diminishes over time. If MIGS does not provide sufficient pressure control, further surgical intervention — such as trabeculectomy or a tube shunt — may be required.
Will I still need eye drops after MIGS?
Many patients are able to reduce their number of eye drops after MIGS. However, it is uncommon to be able to stop all drops entirely after MIGS alone. The goal is usually to improve pressure control and reduce the medication burden, not necessarily to eliminate drops completely.
How long does recovery take after MIGS?
Recovery after MIGS is generally faster than after trabeculectomy. Most patients experience improved or stable vision within days to weeks after the procedure. Post-operative restrictions — such as avoiding strenuous activity and swimming — typically apply for 2 to 4 weeks.
Is MIGS a new or experimental procedure?
No. Several MIGS devices and techniques have been in clinical use for over a decade and have a well-established evidence base. They are performed routinely by specialist glaucoma surgeons worldwide and are supported by international glaucoma society guidelines.
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