Gentle, Effective Options to Lower Eye Pressure and Protect Your Vision

If you’ve been diagnosed with glaucoma, you may already be using daily eye drops to control the pressure inside your eyes. But for some patients, medication alone isn’t enough—or may become less effective over time. That’s where minimally invasive glaucoma surgery (MIGS) can help.

At Arbor Eyecare, we offer a range of microincisional procedures that can lower eye pressure, reduce your dependence on drops, and preserve your vision—all with a gentler approach and faster recovery than traditional glaucoma surgery.

What Is MIGS?

Minimally invasive glaucoma surgery (MIGS) refers to a group of outpatient procedures designed to reduce pressure inside the eye using microscopic tools and tiny incisions. These techniques are often performed at the same time as cataract surgery or as a standalone procedure.

What’s Possible in Glaucoma Surgery at Arbor Eyecare

Depending on your eye health, stage of glaucoma, and previous treatments, your doctor may recommend one of the following MIGS procedures:

Microstents

These tiny implants improve the natural drainage of fluid from the eye. They are often inserted during cataract surgery and can provide long-term pressure reduction with little to no maintenance. You won’t be able to see or feel the stent once it’s in place.

Goniotomy

This procedure involves removing a tiny section of the eye’s internal drainage tissue using a microblade or special tool. It helps fluid flow more easily and is often combined with cataract surgery for a more comprehensive result.

Canaloplasty

This technique involves gently opening and flushing the eye’s natural drainage canal. A special microcatheter is used to dilate the canal and may leave a small stent or tensioning suture to keep it open. Canaloplasty can be done with or without cataract surgery and does not involve creating a permanent opening in the wall of the eye.

Sustained-Release Implants: Alternatives to Daily Drops

Some patients may benefit from advanced glaucoma therapies that gradually release medication inside the eye, reducing or even eliminating the need for daily eye drops. These options are typically performed as quick outpatient procedures and can be a good fit for patients who have difficulty with drop schedules or medication side effects.

Two options currently available include:

• A biodegradable implant that slowly releases medication over several months and naturally dissolves. This treatment can be repeated depending on your response.

• A long-acting implantable device designed to deliver a continuous dose of glaucoma medication for up to three years. When it loses effectiveness, it can be replaced to continue controlling pressure.

Recovery is typically gentle—most patients return to normal activities within a week. (The exception is goniotomy, where we recommend avoiding heavy lifting for about four weeks.) While some patients may still need eye drops after treatment, many find they need fewer medications. Your surgeon will recommend the option—or combination of treatments—that best fits your individual needs.

Is MIGS Right for You?

MIGS is typically recommended for patients with mild to moderate glaucoma who haven’t reached their pressure goals with laser therapy or eye drops alone. It may also be an option for patients experiencing side effects from medication or struggling to keep up with multiple prescriptions.

If you’re preparing for cataract surgery and have glaucoma, combining both procedures may be an excellent opportunity to protect your vision and simplify your care.

Questions? We’re Here to Help

At your pre-surgical consultation, Dr. Rebecca Dale will walk you through the pros and cons of your options and answer your questions. If you're an established patient, we encourage you to send us a secure message through the Patient Portal or give us a call. New to our practice? Call us at (425) 831-2020 or fill out the form below to take the next step in your glaucoma care.