MIGS (ijectW & Hydrus)

Patients can now have a glaucoma procedure at the same time as cataract surgery. This is called MIGS.

What is Glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve and is often caused by increased Intraocular pressure in the eye. Glaucoma is a very difficult disease because it is often difficult to diagnose, and patients do not often even feel anything is wrong. Hence, the reason why glaucoma is often called the sneak thief of sight.  Over 90% of people with glaucoma may have no signs or symptoms because the peripheral (side) vision is usually lost first. Most loss of vision from glaucoma is preventable if the disease is treated early enough. If left untreated, the IOP will increase and irreversible damage to the optic nerve will occur. 

Over the past 5 years, there has been an increase in amazing innovations in glaucoma management procedures. The options for treatment have been improved primarily in a category known as MIGS or (micro-incisional-glaucoma surgery). 

Dee Stephenson, MD has now brought MIGS capabilities to her patients in the Venice, Florida area. If you have glaucoma and would like to consult with us or want a second opinion on your glaucoma diagnosis, please feel free to contact us directly. 

These procedures are exciting from a patient’s perspective because they are generally safer with quicker recovery times. – Dee Stephenson, MD

The MIGS glaucoma surgery allows our practice to offer in one procedure a solution for cataracts and decreased IOP with glaucoma. The IOP created by glaucoma will be improved through a series of small incisions that fix the outflow pathways as opposed to bypassing the drainage system. (What typically happens in traditional glaucoma surgery). Although the MIGS procedure is not a 100% fix for solving the glaucoma problem, and the IOP is not dramatically reduced, it will make the risk of getting the IOP almost impossible. Many patients and doctors like this procedure due to the safety elements versus the risk of other glaucoma surgeries. So, the goal for MIGS surgery during cataract surgery is to achieve a lower IOP that will result in a medication reduction and to address regular non-compliance by the patient. 

How do I know if MIGS will treat my specific case of Glaucoma?

Answering this question will be very difficult with consulting your ophthalmologist. Because of the varying types of glaucoma, every patient is going to need an individual treatment plan. Please consult us for an opinion if MIGS is right for you. 

Are You a MIGS candidate? 

Typical MIGS candidates:

  • Are not a patient type that is diagnosed for severe progression 
  • Will have both cataracts and glaucoma
  • Have varying IOP despite using eye drops 
  • Often have trouble remembering to take glaucoma eye drops


From a safety perspective, MIGS have been favorably reviewed by the Ophthalmic community and are safer than traditional glaucoma surgeries like trabeculectomy and shunt surgeries. Despite this general consensus it is important to note that long term studies have not yet taken place. 

What risks does MIGS procedures present? 

The actual risks related to MIGS procedures are extremely low. Since the procedure is done alongside cataract surgery more of the risks will come into play here. It is normal to experience a small amount of bleeding at the point where the device is inserted. If you have mild or moderate glaucoma and are fine with a surgical procedure, MIGS might be an option for reducing intraocular pressure.

MIGS procedures performed at Stephenson Eye Associates:

  • Hydrus Microstent
  • Istent inject® W

Hydrus Microstent?

The Hydrus implant is a microscopic device the size of an eyelash that stents the trabecular meshwork or drainage canal open and improves outflow capability, thus lowering your eye pressure. This stent is also performed only at the time of cataract surgery for patients with mild to moderate open-angle glaucoma.

Istent inject® W

To help control intraocular pressure, two tiny iStent inject® W stents are gently inserted into your eye during cataract surgery. The iStent inject® W stents create two bypasses, or openings, between the front part of your eye and its natural ability to drain fluid. Once inserted, you will not be able to see or feel the stents, but they will be working to help reduce your eye pressure.


Stephenson Eye Associates

200 Palermo Pl.
Venice. FL 34285

Surgery Center at St. Andrews

1350 East Venice Ave.
Venice, FL 34285