Table 1.

Available MIGS devices and mechanism of action

Mechanism	Example	Outflow Pathway	FDA approval
Increase in trabecular outflow	1. iStent/ iStent inject	Implant is inserted through trabecular meshwork to Schlemm’s canal	• Mild-moderate open angle glaucoma (OAG) in conjunction with cataract surgery
	2. Hydrus implant
	3. Ab-interno trabeculotomy with Trabectome device or Kahook dual blade	Removes the trabecular meshwork and inner wall of Schlemm’s canal	• Medically uncontrolled primary or secondary OAG with or without cataract extraction
	4. Gonioscopy assisted transluminal trabeculotomy (GATT)	Gonioscopic guided ab-interno trabeculotomy using microcatheter (iTrack) or sutures (prolene/ nylon) after performing a 1-2 mm goniotomy
	5. Ab-interno canaloplasty using iTrack	Ab-interno viscodilatation of Schlemm’s canal	• Mild-moderate POAG with or without cataract surgery
	Cypass		• Cypass withdrawn from market
Increase in uveoscleral outflow	Solx Gold shunt	Implants are inserted into suprachoroidal space after creating a localized cyclodialysis	• Not yet approved
	iStent supra		• CE approved for mild-moderate POAG with or without cataract surgery, but not yet FDA approved
Subconjunctival filtration	Xen implant	Implant is inserted through trabecular meshwork to subconjunctival space	• Medically uncontrolled POAG, pseudoexfoliation or pigmentary glaucoma patients or refractory glaucoma after failed previous surgery with or without cataract surgery
	Innfocus		• Not yet approved
Decrease in aqueous humour production	Endolaser Cyclophotocoagulation	Ab-interno cyclophotocoagulation to ablate ciliary processes by direct visualization	• Refractory glaucoma with or without cataract surgery
			• In medically controlled glaucoma in combination with cataract surgery