MIGS, or minimally invasive glaucoma surgery, refers to several different procedures that use microscopic tools and incisions to treat the advanced stages of glaucoma. These procedures have the same basic goal of traditional glaucoma surgery, which is the prevention or reduction of damage to the optical nerve by reducing internal eye pressure. MIGS procedures have been shown to be much safer than traditional glaucoma surgery, have fewer complications, and can be performed on varying stages of the disease. We provide glaucoma evaluations at our facilities throughout Rhode Island, including Providence, Warwick, North Kingstown, Johnston, Woonsocket, and Wakefield. Schedule your evaluation with a Koch Eye Associates glaucoma specialist to find out which MIGS procedure could be right for you.
Diode Laser – This procedure slows the production of fluid within the eye by eliminating part of the source of the fluid. The decrease in fluid production eases the buildup, and therefore, the pressure on the optical nerve. This treatment can be done in-office and is usually tolerated by the patient quite well. There is often a significant reduction in eye pressure after only one treatment.
iStent – The smallest medical device ever implanted into humans, the iStent has been approved by the FDA since 2012 for glaucoma treatment. It is a micro-bypass medical device that creates a pathway through the eye to encourage the built-up fluid to drain more easily, reducing optical pressure.
SLT Laser – Selective light therapy (SLT) is a nonthermal nano-second laser that stimulates the body’s natural production of ocular proteins. This promotes the circulation and elimination of built-up fluid, which in turn lessens internal eye pressure. SLT can be combined with other types of MIGS procedures or used as a standalone treatment.
Iridotomy Laser – Iridotomy laser has been the most commonly used treatment for open-angle glaucoma since 1984. This procedure works by widening the drainage pathway for the built-up internal fluid. The easier drainage then lessens the internal eye pressure.
Micropulse Cyclophotocoagulation Laser Surgery – This procedure can be tailored and adjusted to treat many types and stages of glaucoma with positive results. The procedure enables trapped fluid within the eye to drain by warming the surrounding ciliary tissues. The drainage decreases the internal eye pressure, which can often prevent or slow the development of the disease.
"I first went to Koch Eye many years ago after being referred there for a follow up appointment after being treated at the emergency room for an eye injury, That was the only time I actually saw Dr. Koch himself (who was very nice by the way) It is only in the last few years (since my old lady eyes have begun to need reading glasses) that I have come in regularly for my eye exam and glasses prescription. I never have any problem with wait time because there are several optometrists. Really the only thing I am not crazy about is their hours. I wish it was possible to get an evening appointment or that there was an occasional Saturday. The office staff is pleasant and courteous"- I.C. / Yelp / May 09, 2019
"I have been going to Koch Eye for years. The girls at the front desk are always nice and knowledgeable. I had a new doctor that I haven’t had in past appointments Dr. Vania Bea. From the time she walked in the room she completely put me at easeShe listened to my concerns and i felt confident in her answers. Everyone at Koch in Johnston are great."- M.J. / Google / Feb 10, 2020
"I dont hand out 5 stars all to often, but koch earn it, from the moment you call them you know your dealing with a professional outfit. Your eye sight is very important, and as far as I can see, Koch is top knotch."- C.T. / Google / Feb 10, 2020
"I was pleasantly surprised. Everyone there from the receptionists to the nurses and doctors went above and beyond. I was extremely nervous and everyone went out of their way to make me feel relaxed. Surgery was a success, back in a week for my second eye."- C.B. / Google / Dec 31, 2019
"The staff was great good exam. They took the time to explain what and why the we’re doing"- A.R. / Facebook / Jan 30, 2020
To know whether you are a candidate for MIGS, you need to be evaluated by an ophthalmologist specializing in glaucoma. Each of the many types of glaucoma can have varying degrees of severity so each patient needs a customized procedure to manage his or her symptoms. During your evaluation at Koch Eye Associates, your ophthalmologist will be able to tell you whether you are a candidate and which procedure is your best course of action. The most eligible patients for MIGS:
- Are over the age of 18
- Have not experienced relief from prescription eye drops or other treatments
- Have both glaucoma and cataracts at the same time
- Have mild to moderate glaucoma
What to Expect
Most of our MIGS treatments are outpatient procedures that are performed at the St. James Surgery Center in Warwick, RI. Prior to your treatment, we will administer numbing eye drops to both of your eyes so you should not feel any discomfort throughout the procedure. We can also give you additional sedation or anti-anxiety medication if you feel it is necessary. When the numbing drops have taken effect, a device will be placed over your eyes that will keep you from blinking or moving your eyeballs. Each MIGS treatment process will vary from patient to patient at this point, depending on the procedure. The procedures are all quite quick, lasting only a few minutes.
As is stated in the name, these procedures are minimally invasive so they do not typically require very much recovery time. After your procedure, a member of our team will give you your detailed aftercare instructions, which are extremely important and must be carefully adhered to. We will also ask that you come back for several follow-up appointments so that we can monitor your healing progress. The follow-up visits also allow us to determine whether you might need additional treatment for the progression of glaucoma.
Fight Back Against Glaucoma
Until quite recently, traditional glaucoma surgery was the only available treatment for patients who were past the early stages of the disease. Fortunately, we now have MIGS, which can decrease glaucoma symptoms and improve vision without the painful, drawn-out recovery time. At Koch Eye Associates, we are proud to provide MIGS with the most cutting-edge technologies in the field to help you control your glaucoma. If you think you might be a candidate, we strongly encourage you to contact one of our Rhode Island facilities today to come in for a MIGS evaluation.