On account of the remarkable advancements in glaucoma management technologies in the last several years, millions of patients with glaucoma can take advantage of a whole new world of approaches to managing their disease. An innovative form of treatment for addressing all kinds of different types and stages of glaucoma is minimally invasive glaucoma surgery (MIGS). There are numerous types of tools and techniques that are used for MIGS, but our office specializes in using the Kahook Dual Blade® system. This enables us to create nearly indistinguishable incisions to alleviate abnormal pressure buildup in the eye to prevent further damage to the optical nerve. MIGS generally has fewer post-surgery complications, and most ophthalmologists believe it is safer than traditional glaucoma surgery (trabeculectomy). Contact the Cataract & Refractive Institute of Florida in Cape Coral, Lehigh Acres, or Bonita Springs, FL to schedule your MIGS consultation with board-certified ophthalmologist Dr. James Croley today to learn more.
No one but an experienced ophthalmologist, like Dr. Croley, can judge if someone is a good candidate for MIGS, but it is often used to treat mild to moderate stages of glaucoma. Every type of glaucoma can have a range of stages that present varying symptoms, which is why we create personalized procedure plans for each patient. The best patients eligible for MIGS:
- Aren't able to ease their internal eye pressure with eye drops
- Are suffering from mild to moderate glaucoma
- Aren't at an elevated risk for severe progression
At the Cataract & Refractive Institute of Florida, our team is proud to offer MIGS for our glaucoma patients. As soon as we have established that you are a great candidate for MIGS, we can start building your custom treatment plan and schedule your surgery accordingly. Our team specializes in utilizing state-of-the-art technology for MIGS. MIGS is an alternative to other treatment options for glaucoma, and there continues to be a large amount of research to further advance the tools and technologies for MIGS. Dr. Croley and his skilled eye care team provide various types of procedures that fall into this less invasive method of treating glaucoma. There are four basic categories of treatments, including:
Increasing trabecular outflow
These procedures are designed to increase the outflow of fluid from the eye by treating the juxtacanalicular system and/or trabecular meshwork. The increased resistance of fluid flow out of the eye through the trabecular meshwork is felt to be the primary source for the development of open-angle glaucoma. The procedures are designed to either bypass or remove the trabecular meshwork and inner wall of Schlemm’s canal located behind the trabecular meshwork. The fluid can then pass through the collector channels in Schlemm’s canal to be removed from the eye. In patients with high episcleral venous pressure, these procedures may not be effective. Patients who have had retinal detachment procedures with a scleral buckle, Grave’s disease, and need very low eye pressures.
The supraciliary space for fluid outflow has been used for the treatment of glaucoma for decades. There were many complications related to the older procedures using the supraciliary space. The newer procedures are having very good success.
Reducing aqueous humor production
Aqueous humor is the transparent fluid that exists between the lens and cornea in the front of the eye. In order to treat glaucoma, Dr. Croley and his team utilize advanced technology to reduce the production of the aqueous humor fluid, including the Endocyclophotocoagulation (ECP) laser device, Micropulse P3 Cyclophotocoagulation, and the Cyclo Probe.
Dr. Croley and his team provide two forms of subconjunctival filtration: Xen Gel Stent and InnFocus Microshunt. The XEN gel stent is indicated for use in patients with open-angle glaucoma, pigmentary glaucoma, and/or pseudoexfoliation glaucoma. The stent is pushed through the sclera ab interno into the subconjunctival space. The fluid that filters through the stent forms a filtering bleb of the conjunctiva where the fluid is absorbed. The InnFocus Microshunt may be placed by itself or in conjunction with cataract surgery. After local anesthesia is obtained, a small conjunctival peritomy or incision is made usually superiorly on the eye. A needle is used to create a tunnel through the sclera into the anterior chamber. The tip of the shunt is then passed into the anterior chamber and the conjunctival incision is closed.
MIGS with the Kahook Dual Blade system is considered an outpatient procedure. This is done in conjunction with cataract surgery as an outpatient procedure and takes a total of 10 – 15 minutes to complete. Since this procedure is minimally invasive, the recovery time is quite shorter compared with other glaucoma procedures. Almost all patients are able to return to work and their usual routines within 48 hours to one week. When the procedure is done, we will thoroughly explain post-surgery instructions for how to care for your eyes during your recovery time. In addition, we will schedule follow-up exams at the Cataract & Refractive Institute of Florida so we can carefully monitor your intraocular pressure over the course of your healing period.
Until very recently, patients with glaucoma only had one choice for treatment. Thankfully, MIGS now enables us to help patients control their glaucoma and prevent further damage to their optical nerve. Contact the Cataract & Refractive Institute of Florida to schedule a MIGS consultation with our skilled team to discover if this procedure is right for you. We offer clinic locations in Cape Coral, Lehigh Acres, and Bonita Springs, FL.