Table 1.
Summary of MIGS devices and techniques.
| Device Category | Device(s) (Manufacturer(s)) | FDA Approval Year | Brief Description | Mechanism of Action | Indication |
|---|---|---|---|---|---|
| Trabecular Outflow | Trabectome (NeoMedix Corporation) | 2004 | A microelectrocautery device that ablates and removes a portion of the trabecular meshwork and the inner wall of Schlemm’s canal. | Trabecular Meshwork Removal | Moderate-to-severe glaucoma |
| Kahook Dual Blade (New World Medical) | 2015 | An instrument with a dual-sided tip for precise incisions to create a trabecular meshwork window. | Trabecular Meshwork Removal | Moderate-to-severe glaucoma | |
| iStent (Glaukos Corporation) | 2012 | The first trabecular micro-bypass stent implanted to enhance aqueous humor outflow. | Trabecular Bypass | Mild-to-moderate OAG | |
| iStent Inject (Glaukos Corporation) | 2018 | A preloaded injector system that implants two stents to enhance IOP reduction. | Trabecular Bypass | Mild-to-moderate OAG | |
| HFDS (Oertli Instrumente) | NA | Creates six pockets penetrating 1 mm deep into the trabecular meshwork and Schlemm’s canal. | Deep Sclerotomy | Moderate-to-severe OAG | |
| Schlemm’s Canal Targeted | TRAB360 (Sight Sciences) | 2013 | A device utilizing a flexible microcatheter to cannulate and viscodilate Schlemm’s canal. | Trabecular Bypass | Mild-to-moderate OAG |
| OMNI Surgical System (Sight Sciences) | 2017 | A two-step device that combines viscodilation of Schlemm’s canal and trabeculotomy to enhance aqueous humor outflow. | Viscodilation and Trabeculotomy | Mild-to-moderate OAG | |
| Streamline (New World Medical) | 2021 | A single-use device that creates a goniotomy and delivers viscoelastic material to dilate Schlemm’s canal. | Goniotomy and Canal Dilation | Mild-to-moderate OAG | |
| ABiC (Ellex iScience) | NA | Uses a microcatheter system to cannulate and dilate Schlemm’s canal and distal outflow channels with viscoelastic material. | Canal Dilation | Mild-to-moderate primary OAG | |
| Schlemm’s Canal and Trabecular Outflow | Hydrus Microstent (Ivantis Inc.,) | 2018 | A flexible, biocompatible nitinol stent implanted via a clear corneal incision. | Canal Dilation and Trabecular Bypass | Mild-to-moderate OAG |
| Gonioscopy-Assisted Procedures | GATT | Not Device-Dependent | A procedure that utilizes a microcatheter and flexible suture for a 360-degree trabeculotomy. | 360-degree Trabeculotomy | Moderate-to-severe glaucoma |
| Suprachoroidal Outflow | iStent Supra (Glaukos Corporation) | NA | A PES device with a porous titanium coating implanted to facilitate aqueous humor drainage into the suprachoroidal space. | Suprachoroidal Bypass | Moderate-to-severe glaucoma |
| Subconjunctival Shunts | EX-PRESS Glaucoma Filtration Device (Alcon Laboratories) | 2002 | Small, stainless-steel shunt that is available in two sizes: P-50 (50 microns) and P-200 (200 microns). | Bypasses the Trabecular Meshwork | Moderate-to-severe glaucoma |
| Xen Gel Stent (Allergan) | 2016 | Hydrophilic, porcine-derived gelatin material, implanted to create a new drainage pathway that bypasses the trabecular meshwork. | New Drainage Pathway | Moderate-to-severe glaucoma | |
| PreserFlo MicroShunt (Santen) | 2021 | A small, flexible SIBS tube diverting aqueous humor from the anterior chamber to the subconjunctival space. | Diverts Aqueous Humor | Moderate-to-severe glaucoma |
ABiC = Ab Interno Canaloplasty; GATT = gonioscopy-assisted transluminal trabeculotomy; HDFS = high-frequency deep sclerotomy; OAG = open-angle glaucoma; PES = polyethersulfone; NA = not applicable; SIBS = poly(styrene-block-isobutylene-block-styrene).