To evaluate the treatment effect of 2nd-generation Micro Invasive Glaucoma Surgery (MIGS) devices.

METHODS:

A systematic literature review was conducted to assess the outcomes of the procedure. The outcomes were the reduction in intra-ocular pressure (IOP) and reduction in IOP lowering topical medications. The electronic search

was performed using MEDLINE via the PubMed interface from January, 2015 to November, 2019. The inclusion criteria were: English language, comparative studies of interventions to lower IOP via surgical device; 6 month or greater follow-up; and human only studies. A single investigator reviewed the articles and extracted all articles. A second investigator reviewed the results of the search and extraction of data and through a consensus approached resolved any discrepancies.

RESULTS:

A total of 142 articles were identified during the initial search. After review of title and abstract 38 articles were identified for full paper review. Ultimately, 10 articles met the inclusion criteria and were fully extracted. In cases of bilateral eyes being treated; two eyes were considered rather than one patient. Collectively, a total of 2,906 eyes evaluated. Of the 10 studies extracted, they had an average follow-up of 16.3 months (median 12 months). Success rates for reductions in IOP and IOP lowering topical medications were observed to have met the pre-determined levels of efficacy set forth in the individual studies. However, there was great heterogeneity of the pre-determined reductions and how they were reported. It was not possible quantitatively assess these outcomes.

CONCLUSIONS:

This systematic review of MIGS devices suggests that they successfully lower IOP and topical medication usage. However, more research is necessary using standardized efficacy-measuring metrics to quantitatively assess the benefits. Physicians that manage open-angle glaucoma should be well educated on the different levels of ocular tissue damage incurred by different surgical approaches