Clinical Scorecard: Essential MIGS Skills
At a Glance
| Category | Detail |
|---|---|
| Condition | Glaucoma; minimally invasive glaucoma surgery (MIGS) |
| Key Mechanisms | The discussion categorized MIGS by aqueous destination or target: the trabecular canal, suprachoroidal space, subconjunctival space, or aqueous production. Procedures discussed included trabecular microbypass stenting, ab interno goniotomy and/or viscodilation, and supraciliary stenting. |
| Target Population | Ophthalmologists, including comprehensive ophthalmologists and cataract surgeons; the discussion concerned interventional approaches for glaucoma patients. |
| Care Setting | Ophthalmic surgical practice; the course presented practical techniques, device considerations, and cases for everyday practice. |
Key Highlights
- The AAO 2026 course covered microscope setup, gonioscopic techniques, and approaches to ab interno glaucoma surgery.
- Devices discussed included iStent and Hydrus trabecular microbypass stents; systems for goniotomy and/or viscodilation; and the AlloFlo Uveo supraciliary stent.
- Dr. Brubaker discussed understanding device features, attending to the angle of approach, and adjusting technique if a second attempt is needed.
- Dr. Camejo said thoughtful MIGS selection can individualize glaucoma care while reducing medication burden, improving the ocular surface, and preserving the opportunity to meet refractive goals, visual expectations, and quality-of-life needs.
Guideline-Based Recommendations
Diagnosis
Management
Monitoring & Follow-up
Risks
Patient & Prescribing Data
The discussion concerns glaucoma patients; it provides no specific eligibility criteria or patient-level prescribing data.
Dr. Camejo stated that thoughtful MIGS selection can reduce medication burden, improve the ocular surface, and preserve the opportunity to meet refractive goals, visual expectations, and quality-of-life needs. The source provides no comparative outcomes or dosing information.
Clinical Best Practices
- Course topics included microscope setup and gonioscopic techniques for ab interno procedures.
- Dr. Brubaker described differences among Hydrus and iStent iterations and advised understanding the device and attending to the angle of approach.
- Dr. Brubaker discussed adjusting technique if a second attempt is needed.
- The course used practical cases and examples to discuss MIGS use in everyday practice.
Related Resources & Content
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