Abstract
Glaucoma, a leading cause of irreversible vision loss worldwide, is managed by reducing intraocular pressure (IOP) using medications, lasers, or surgical procedures. While traditional glaucoma surgeries are highly efficacious, potential complications have led to the search for safer yet effective alternatives. Over the past decade, minimally invasive or micro-invasive glaucoma surgery (MIGS) has emerged as a revolutionary strategy to not only reduce IOP, but also medication burden while minimizing surgical risks. This article provides a comprehensive review of both approved and investigational MIGS procedures, focusing on their key features and clinical outcomes. The American Glaucoma Society Classification of MIGS is used as a framework for analysis. MIGS as both a standalone procedure and in combination with cataract extraction are reviewed. Only a subset of MIGS procedures have undergone rigorous evaluation in randomized clinical trials, and prospective data directly comparing different MIGS techniques are limited. High-quality studies will be essential to guide clinicians in determining the optimal approach to incorporating MIGS into their surgical paradigm. MIGS is a dynamic, evolving field that will continue to provide a plethora of surgical options with the goals of safety, efficacy, and rapid visual recovery for glaucoma patients.