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Q. Can minimally invasive glaucoma surgery be done in sensitive eyes with glaucoma?

Answered by
Dr. Manjunath Natarajan
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jun 20, 2019

Hello doctor,

My mom is a glaucoma patient for the last 10 years. She has been on medications like eye drops including Azopt, Ganfort, Alphagan, Vigamox, and prior to them Cosopt (which did not suit her). She has gone through retina eye laser and also has been injected in both her eyes almost 22 times for retinal leakage as well, has also gone through cataract eye surgery 16 years ago. At the moment her eye pressure remains between 21 to 24. The doctor says implants are necessary as she can see very less now. Given her eye condition is sensitive, a doctor has suggested that it is best to operate her with Ahmed valve implant, however, it has its own risks. I wanted to know if it is better to try the latest option, called MIGS (minimally invasive glaucoma surgery) like Xen Gel Stent and InnFocus Microshunt as it has near to no complications. I want to get an opinion about this before thinking about Ahmed valve.

Dr. Manjunath Natarajan

Ophthalmology (Eye Care)


Welcome to

I am very sorry to hear about your mother's eyes. I suspect that she must have undergone the retina laser and the injections for a condition called as diabetic retinopathy. I feel that most likely it is a complication of diabetic retinopathy that might have caused a high pressure in her eyes. Xen gel stent is currently FDA approved for refractory glaucoma not caused by diabetic neovascularization and Inn focus micro shunt is currently being tested for long term side effects and usefulness in such situations.

I must be clear in letting you know that neovascular glaucoma is a very adamant disease to treat and the treatment may not be straightforward and may require multiple procedures and reviews with the treating doctor, yet the most often agreed upon surgery, across most hospitals in the world is currently Ahmed glaucoma valve, along with of course the laser and injections. In case you need further clarification or if your mother is not a diabetic, please send a scanned copy of all her doctors records and prescriptions. I will do my best in helping you understand the situation.

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