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
"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
"I had been going to Vision World/ Works for the last 20 years for eye exams, glasses, contacts. When I was last seen a few years ago I was told my eyes had weakened and I needed -6.0 in my left eye and -5.0 in my right, a substantial increase from -4.75 left and -3.75 right two years before. Needless to say I experienced hyperopia and needed readers for the first time. I wasn't able to read labels, see my phone, or use a laptop without readers of at least +2.5. I was recentl...y seen by Dr Besen at Koch Eye who prescribed contacts of -5.25 left and -4.25 right. I'm absolutely certain that Vision World had me in lenses that were too strong because now I can see my laptop without readers, and I can see my phone if I hold it at arms length. Not only can I see better (for distance as well as close up), but the entire experience of walking into Koch, being greeted by reception, having a preliminary exam by the optician assistants, receiving a full eye exam by the optometrist, being properly fitted for glasses by the optician, and checking out with reception, is exponentially superior with Koch. Clearly the entire staff enjoy their careers, and are friendly, professional, and completely competent. Thank you, Koch Eye Associates! I will recommend you to everyone I know. Sincerely, Kate Carroll"- K.C. / Facebook / Nov 13, 2019
"I had an excellent cataract removal experience with the well coordinated surgery team at St James Surgery Center. They put a very personal touch on a professionally orchestrated surgical process. Everything from intake/insurance approval thru going home instructions was clear. The center is easy to get to with plenty of parking. The surgery prep room made me think, "this is a really good team - lots of smooth handoffs and cross checking to insure accuracy! There were a bunch of chairs that convert to operating tables and they move patients in and out at an impressive pace. Well oiled machine!! They were a friendly and (seem like a) happy crew! What I really liked was the results of my surgery!! Dr Sayeah is friendly and confident, justifiably proud of the skills he has mastered. He gives people their sight back for a living! Needless to say, I'm thrilled to see with real clarity (and in color!!) again!!"- R.W. / Google / Sep 24, 2020
"Had LASIK on 8/14/2020, great experience, I was well informed of what to expect. No surprises. Dr. Gerber was very professional and has good bed side manners. For my follow up the next day I saw Dr. Bae and she was very nice, friendly and sweet. The entire staff at all the locations I have visited for eye exams, purchase glasses and/or contacts have been very nice. Very nice and clean locations, everyone wears a mask and practice social distancing as much as possible. I am glad I had this team for my surgery and my family eye care needs."- S.R. / Yelp / Aug 25, 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.