# The Efficacy and Safety of Minimally Invasive Glaucoma Surgery for Primary Open-Angle Glaucoma: A Systematic Review

## TL;DR

Minimally invasive glaucoma surgery (MIGS) is a safe and effective option for lowering eye pressure in patients with primary open-angle glaucoma.

## Contribution

This systematic review provides evidence that MIGS is as effective as traditional glaucoma surgeries for managing intraocular pressure.

## Key findings

- MIGS is as effective as other invasive procedures in lowering intraocular pressure.
- MIGS leads to favorable outcomes with reduced medication use compared to other glaucoma treatments.
- Short-term trials confirm the safety and efficacy of MIGS for primary open-angle glaucoma.

## Abstract

What are the main findings?
Minimally invasive glaucoma surgeries (MIGSs) and implants serve as a safe and effective option to lower intraocular pressure.The lowering of intraocular pressure with MIGS is comparable to other invasive procedures and surgeries that are proven in the management of glaucoma.

Minimally invasive glaucoma surgeries (MIGSs) and implants serve as a safe and effective option to lower intraocular pressure.

The lowering of intraocular pressure with MIGS is comparable to other invasive procedures and surgeries that are proven in the management of glaucoma.

What is the implication of the main finding?
The healthcare system may benefit from the widespread use of MIGS, as the training needed is minimal and the recovery time post-surgery is as short as that for cataract extraction.It is obvious that MIGSs are going to remain important in the foreseeable future, and healthcare systems will need to invest resources in studying their long-term safety and efficacy.

The healthcare system may benefit from the widespread use of MIGS, as the training needed is minimal and the recovery time post-surgery is as short as that for cataract extraction.

It is obvious that MIGSs are going to remain important in the foreseeable future, and healthcare systems will need to invest resources in studying their long-term safety and efficacy.

Healthcare systems worldwide are burdened significantly due to glaucoma, which is a leading cause of irreversible blindness. A total of 76 million are currently affected, and it is estimated that by the year 2040, 112 million will be affected by glaucoma. Minimally invasive glaucoma surgery (MIGS) is a recent innovation that plays a key role in glaucoma management. We aimed to conduct a systematic review of the safety and efficacy of MIGS devices and procedures and their use in primary open-angle glaucoma (POAG) to lower intraocular pressure (IOP). Methods: A comprehensive electronic search of the PubMed database was conducted, and randomized controlled trials (RCTs) comparing MIGS devices and techniques with cataract surgery or other glaucoma procedures that had been published by 1 May 2025 were included. Results: Thirty RCTs were included in the systematic review. Studies show that MIGSs are as safe and effective as other procedures, including phacoemulsification and trabeculectomy, at lowering IOP. Conclusions: Short-term trials indicate that MIGSs are a safe and effective treatment option for primary open-angle glaucoma. MIGS procedures lead to favorable outcomes, including decreases in mean IOP and medication use, compared with other glaucoma procedures or standalone phacoemulsification. Independent long-term follow-up studies are needed further to elucidate the efficacy and long-term safety of MIGS.