Minimally Invasive Glaucoma Surgery (MIGS)
Harley Street, London
Minimally Invasive Glaucoma Surgery (MIGS) represents a paradigm shift in glaucoma treatment, offering effective intraocular pressure reduction with dramatically improved safety profiles and faster recovery times. The latest generation of MIGS devices, including the innovative iStent infinite, provides patients with gentle yet effective treatment options that preserve tissue and maintain quality of life whilst controlling this sight-threatening condition.
Miss Shreya Haldar’s expertise with the newest MIGS technologies ensures that patients receive the most advanced treatment options available, often combined with cataract surgery for maximum convenience and effectiveness. This approach transforms glaucoma treatment from a major surgical undertaking to a gentler intervention that fits seamlessly into patients’ lives.
Understanding MIGS Technology
MIGS procedures work by creating new drainage pathways for aqueous humour or enhancing existing drainage systems within the eye. Unlike traditional glaucoma surgery that creates drainage outside the eye, MIGS procedures typically work within the eye’s natural anatomy, leading to fewer complications and faster healing.
The revolutionary aspect of MIGS lies in its tissue-sparing approach. Traditional filtering surgeries require significant manipulation of the conjunctiva and sclera, creating scarring that can affect future surgical options. MIGS procedures preserve these tissues, maintaining options for future treatment if needed.
The minimally invasive nature of these procedures means they can often be performed through the same small incision used for cataract surgery. This combination approach addresses two common age-related eye conditions simultaneously, providing maximum benefit with minimal disruption to patients’ lives.
The iStent infinite Advantage
The iStent infinite represents the latest evolution in trabecular micro-bypass technology. This third-generation device consists of three interconnected titanium stents that create multiple pathways for aqueous outflow through the trabecular meshwork into Schlemm’s canal.
Advanced Design Features
The iStent infinite’s unique design provides enhanced surface area for drainage compared to single stents. The three interconnected stents work synergistically to provide more effective pressure reduction whilst maintaining the safety advantages of minimally invasive treatment.
The device’s titanium construction ensures excellent biocompatibility with no inflammatory response. The micro-size design (less than 1mm) means the stents are virtually invisible once implanted and don’t interfere with normal eye function or future treatments.
Clinical Effectiveness
Clinical studies demonstrate that the iStent infinite provides superior pressure reduction compared to previous generation devices. The enhanced drainage capacity means that more patients achieve target pressures with this single intervention.
The device’s effectiveness in combination with cataract surgery is particularly impressive, with many patients achieving significant pressure reductions that reduce or eliminate their need for glaucoma medications.
Other Advanced MIGS Options
Miss Haldar’s expertise encompasses the full range of MIGS procedures, ensuring that patients receive the most appropriate treatment for their specific type of glaucoma and individual circumstances.
Supraciliary MIGS
These devices create drainage pathways into the supraciliary space, offering alternative routes for aqueous outflow. They’re particularly valuable for patients with certain types of glaucoma or specific anatomical considerations.
Subconjunctival MIGS
Devices that create drainage into the subconjunctival space provide more significant pressure reductions whilst maintaining the safety advantages of minimally invasive techniques.
Trabecular MIGS
Beyond the iStent infinite, other trabecular devices offer different approaches to enhancing conventional outflow. Device selection is tailored to individual patient needs and anatomy.
Ideal Candidates for MIGS
MIGS procedures are particularly beneficial for patients with mild to moderate primary open-angle glaucoma, especially those who also have cataracts. The ability to address both conditions simultaneously makes this an attractive option for many patients.
Primary Indications
Patients with early to moderate glaucoma who require cataract surgery are ideal candidates for combined procedures. The additive effect of lens removal and MIGS implantation often provides excellent pressure control.
Those experiencing side effects from glaucoma medications or having difficulty with medication compliance benefit significantly from MIGS procedures that can reduce or eliminate the need for daily drops.
Patient Advantages
The minimally invasive nature of MIGS procedures means faster recovery and quicker return to normal activities compared to traditional surgery. Most patients resume regular activities within days rather than weeks.
The tissue-sparing approach preserves options for future treatments if glaucoma progresses over time. This is particularly valuable for younger patients who may need additional interventions during their lifetime.
The MIGS Procedure Experience
MIGS procedures are typically performed in conjunction with cataract surgery, though they can be done as standalone procedures when appropriate. The entire process is designed to maximise patient comfort whilst achieving optimal outcomes.
Pre-Operative Preparation
Comprehensive evaluation ensures that patients are appropriate candidates for MIGS procedures. This includes assessment of glaucoma severity, eye anatomy, and overall health status.
Detailed discussions about expectations and outcomes help patients understand the benefits and limitations of MIGS procedures. Realistic expectations are crucial for patient satisfaction.
Procedure Details
The procedure is performed under topical anaesthesia with mild sedation for patient comfort. The same small incision used for cataract surgery provides access for MIGS device implantation.
Device implantation typically adds only a few minutes to cataract surgery time. The precision instruments required for MIGS procedures allow for accurate placement with minimal tissue disruption.
Recovery Process
Recovery from MIGS procedures is typically rapid and comfortable. Most patients experience minimal discomfort and can resume normal activities within a few days.
Post-operative medications include standard cataract surgery drops with possible additional anti-inflammatory treatments. The recovery regimen is designed to optimise healing whilst preventing complications.
Expected Outcomes and Benefits
MIGS procedures offer excellent outcomes for appropriately selected patients. The pressure reductions achieved are typically moderate but clinically significant, often reducing the burden of glaucoma medications.
Pressure Reduction
Studies show that MIGS procedures, particularly when combined with cataract surgery, can achieve 20-30% reductions in intraocular pressure. This level of reduction is often sufficient to reach target pressures in mild to moderate glaucoma.
The pressure reduction achieved with MIGS procedures is generally stable over time, providing durable treatment benefits. Long-term studies continue to demonstrate sustained effectiveness.
Medication Reduction
Many patients experience significant reductions in their glaucoma medication requirements following MIGS procedures. Some patients can eliminate medications entirely, whilst others require fewer drops with reduced side effects.
This medication reduction improves quality of life and reduces treatment costs over time. The elimination of medication side effects is often as valuable to patients as the pressure reduction itself.
Safety Profile
MIGS procedures have excellent safety profiles with very low complication rates. The minimally invasive nature of these procedures significantly reduces the risk of serious complications compared to traditional surgery.
Most complications, when they occur, are minor and easily managed. The tissue-sparing approach means that if complications do arise, they’re typically less severe than those associated with traditional surgery.
Long-Term Monitoring and Management
Successful MIGS procedures require ongoing monitoring to ensure continued effectiveness and eye health. Miss Haldar’s comprehensive follow-up programme tracks pressure control and overall glaucoma status.
Regular Assessments
Post-operative monitoring includes pressure checks, assessment of device function, and overall eye health evaluation. Visual field testing and optic nerve assessment ensure that glaucoma remains stable.
The frequency of follow-up visits is tailored to individual needs and treatment response. Most patients require regular but less frequent monitoring compared to those on complex medication regimens.
Additional Treatments
Some patients may require additional treatments over time as glaucoma can progress despite successful MIGS procedures. The tissue-sparing nature of MIGS means that all future treatment options remain available.
Additional MIGS procedures, laser treatments, or traditional surgery can be performed if needed. The initial MIGS procedure doesn’t compromise future treatment options.
Why Choose Miss Shreya Haldar for MIGS Procedures?
Miss Haldar’s expertise with the latest MIGS technologies ensures that you receive the most advanced treatment available. Her experience with devices like the iStent infinite means optimal placement and outcomes.
Her comprehensive approach to glaucoma care ensures that MIGS procedures are recommended only when appropriate and that all aspects of your glaucoma management are considered. This thorough evaluation leads to better outcomes and patient satisfaction.
Located on Harley Street in London, Miss Haldar’s practice provides access to the most current MIGS technologies and techniques. Her collaboration with device manufacturers and research institutions ensures that patients benefit from the latest advances.
The practice’s commitment to patient education helps you understand the benefits and limitations of MIGS procedures. This knowledge enables informed decision-making and realistic expectations about outcomes.
Miss Haldar’s surgical expertise encompasses both traditional and minimally invasive techniques, ensuring unbiased recommendations about the most appropriate treatment for your specific circumstances.
Experience the revolution in glaucoma treatment with advanced MIGS procedures. Miss Shreya Haldar’s expertise with the latest technologies, including the iStent infinite, provides gentle yet effective treatment for glaucoma.
Contact our Harley Street practice today to discover how minimally invasive glaucoma surgery can preserve your vision whilst maintaining your quality of life. Modern glaucoma deserves modern treatment, and we’re here to provide it.