Micro-Incisional Glaucoma Surgery (MIGS) represents a new generation of minimally invasive procedures designed to reduce intraocular pressure in patients with open-angle glaucoma. Using tiny incisions and specialized micro-scale devices, MIGS procedures offer a safer profile and faster recovery compared to traditional glaucoma surgeries — and are often performed in combination with cataract surgery.
Our practice offers several leading MIGS options, allowing us to tailor treatment to each patient's unique anatomy, glaucoma severity, and surgical goals.
The OMNI® Surgical System is the only device that combines two well-established MIGS procedures into one using a single device and single clear corneal incision. With dual mechanisms of action targeting the trabecular meshwork and collector channels, OMNI® is designed to address the entire natural trabeculocanalicular outflow pathway to reduce intraocular pressure in adult patients with open-angle glaucoma.
1. Trabecular meshwork
Trabeculotomy
2. Schlemm's canal
Canaloplasty
3. Collector channels
Trabeculotomy
The OMNI® Surgical System is indicated for canaloplasty (microcatheterization and transluminal viscodilation of Schlemm's canal) followed by trabeculotomy (cutting of trabecular meshwork) to reduce intraocular pressure in adult patients with primary open-angle glaucoma.
With its unique implant-free approach, the OMNI® Surgical System accesses Schlemm's canal with a microcatheter through a single clear corneal incision. It is intelligently engineered with an internal reservoir delivering a controlled amount of viscoelastic fluid.
To address the trabecular meshwork as a point of resistance within the conventional outflow pathway, the OMNI® Surgical System allows for a titratable trabeculotomy customized to meet your surgical plan.
The Streamline™ Surgical System is a MIGS device designed to perform a targeted trabeculotomy to reduce intraocular pressure in adult patients with open-angle glaucoma. Using a single-use, handheld device, Streamline delivers a precise, ab interno trabeculotomy through a clear corneal incision — without the need for an implant.
The iStent inject® W by Glaukos is the world's smallest FDA-approved medical device. It is designed to reduce intraocular pressure in adults with mild-to-moderate open-angle glaucoma by creating two permanent bypasses through the trabecular meshwork, restoring the eye's natural outflow pathway. The iStent inject® W is typically implanted at the time of cataract surgery.
The Hydrus® Microstent by Alcon is an intracanalicular scaffold designed to reduce intraocular pressure in adults with mild-to-moderate primary open-angle glaucoma. Implanted through a small corneal incision, the Hydrus® expands Schlemm's canal and bypasses the trabecular meshwork — the primary site of outflow resistance — to enhance aqueous outflow. It is indicated for use in conjunction with cataract surgery.
