Objective:

The article examines the objective, findings, and clinical context described in Essential MIGS Skills.

Approach:

• Organizing MIGS options: The course grouped procedures by aqueous outflow or production pathways: the canal, suprachoroidal space, subconjunctival space, and aqueous production.
• Techniques and devices: Topics included microscope setup and gonioscopy; trabecular microbypass stents such as iStent and Hydrus; ab interno goniotomy or viscodilation; and supraciliary stenting.
• Device-specific considerations: Jacob Brubaker described Hydrus as a 90° stent with windows and an inlet, iStent Inject W as having two preloaded stents, and iStent Infinite as having three. He advised attention to approach angles and familiarity with device adjustments if a second attempt i…

Key Findings:

• The discussion presented practical cases and examples intended to help ophthalmologists consider MIGS options in everyday practice.
• Speakers described MIGS selection as involving decisions about when and how to intervene and which procedure to use.
• Larissa Camejo said thoughtful procedure selection can individualize care while reducing medication burden, improving the ocular surface, and preserving refractive and visual goals.
• Steven Sarkisian said trabecular stents such as iStent and Hydrus should be among the tools available to cataract surgeons.

Interpretation:

The speakers framed MIGS as a set of approaches that can be organized by aqueous pathway and selected according to the clinical situation. They advocated broader ophthalmologist familiarity with interventional glaucoma treatment.

Limitations:

• The context describes an educational course and expert discussion; it does not report a clinical study, patient outcomes, or comparative effectiveness data.

Conclusion:

The course emphasized practical device knowledge, gonioscopic technique, and individualized selection among MIGS approaches.

Sources:

• Article context and edited transcript