MICROINVASIVE SURGERY IN GLAUCOMA TREATMENT: PAST, PRESENT AND FUTURE (LITERATURE REVIEW)

Abstract

The high prevalence of glaucoma worldwide and the expected further increase in the number of patients necessitate the search for innovative treatment methods.
Currently, ophthalmology has a wide arsenal of tools for the treatment of glaucoma, including various groups of medications and laser techniques. Cases of insufficient effectiveness or limitations of medical and laser treatment serve as the basis for choosing surgical methods. However, alongside achieving targeted level of intraocular pressure (IOP), modern trends in glaucoma surgery are also directed towards minimizing tissue trauma during surgeries, reducing procedure time, and ensuring a stable and long-lasting hypotensive effect. Over the past decades, numerous techniques of minimally invasive glaucoma surgery (MIGS) have been emerged.

This review was conducted by analysis of current publications dedicated to MIGS, using the PubMed, e-library, Scopus, and Google Scholar databases. The information was systematized and served as the basis for creating the most comprehensive classification of existing MIGS techniques to date, taking into account their technical features, principles, and action mechanisms and impact on various structures of the eye’s drainage system. Data from multicenter studies and meta- analyses are presented, demonstrating the effectiveness, high safety profile, stability of long-term results, and rapid patient rehabilitation with the use of minimally invasive glaucoma surgery. This indicates the undeniable demand and promising nature of MIGS at the mild and moderate glaucoma.

Nevertheless, there is no doubt about the relevance of further research of MIGS field in order to expand its practical indications, with the balance between effectiveness and possible risks.