Dr. David Solá-Del Valle, a glaucoma specialist at Mass. Eye and Ear, breaks down different techniques in glaucoma surgery, including some that are minimally invasive.
As one of the leading causes of blindness in adults, glaucoma is a condition in which pressure builds up in the eye. Over time, the high pressure (known as intraocular pressure) causes loss of vision.
Although glaucoma is a chronic disease that cannot be cured, there are several ways to control it based on its severity. Usually a patient is started on eye drops in an attempt to control the pressure. If that doesn’t work, the next step normally involves surgery or the use of lasers to reduce pressure in the eye. After this course of treatment, if the pressure is not down to where it should be due to a more severe case of glaucoma, more traditional glaucoma surgeries are considered. If you have glaucoma, it’s important to speak with your eye doctor about what treatment is best for you.
David A. Solá-Del Valle, MD, performs approximately 20 minimally invasive glaucoma surgeries a month. He explains these procedures, along with who might be an ideal candidate.
What is minimally invasive glaucoma surgery?
Minimally invasive glaucoma surgery (MIGS) is a group of procedures intended to reduce the pressure that builds up in the eye. “There are many different kinds of MIGS,” said Dr. Solá-Del Valle. When possible, he prefers to combine a few techniques from different MIGS procedures. Some of which decrease fluid production in the eye while others increase the outflow of it.
What is the difference between MIGS and traditional glaucoma surgery?
The procedures are the most notable differences between a traditional surgery and MIGS. Another is recovery time. Dr. Solá-Del Valle explained that his preferred approach for severe cases of glaucoma involves the trabeculectomy and glaucoma drainage devices. These techniques require making a hole in the eye to drain fluid.
What is the typical recovery period?
The biggest benefit of having a less invasive surgery like MIGS is a shorter recovery time. The average recovery period for a traditional surgery is two to three months. It also limits you from bending, lifting heavy objects and using great exertion during that time. While you also have to take it easy after undergoing a MIGS procedure, the recovery period is only one to four weeks.
Who are the best candidates for minimally invasive glaucoma surgery?
Not everyone is a candidate for minimally invasive glaucoma surgery. “I recommend that patients with mild to moderate cases of glaucoma undergo MIGS,” said Dr. Solá-Del Valle. “A person with a severe case of glaucoma will usually benefit from one of the more traditional procedures.”
MIGS works best for people who are already planning on having cataract surgery. It only adds five to 10 minutes to an already scheduled surgery.
Like any other medical situation, Dr. Solá-Del Valle emphasized that each patient is different and should be evaluated on an individual basis.
About Our Expert
Dr. David Solá-Del Valle is a member of the Glaucoma Service at Mass. Eye and Ear. He specializes in adult, young adult and adolescent glaucoma care, as well as the surgical treatment of glaucoma.