Minimally Invasive Glaucoma Surgery

iStent inject W, Hydrus-style MIGS care and complete glaucoma diagnostics

MIGS Glaucoma Surgery —
The Revolution Starts Here

Micro-incision precision, optic nerve protection and complete glaucoma diagnostics. IOP matters, but glaucoma diagnosis also depends on OCT, visual fields, optic nerve assessment and corneal thickness.

+91-6280048805

Peripheral Vision Narrows First

The centre may remain clear while side vision fades, so patients may not notice damage until late disease.

Four-Part Diagnosis

Pressure alone is not enough. OCT nerve scan, visual field testing, optic disc appearance and corneal thickness guide the diagnosis.

MIGS Micro-Stents

iStent inject W and Hydrus-style MIGS pathways can improve drainage through very small incisions in suitable patients.

Best eye surgeon and glaucoma specialist searches: Dr. Varun Baweja evaluates pressure, nerve structure and visual function before recommending drops, laser, cataract-combined MIGS, iStent inject W or Hydrus-based glaucoma care.

IOPOCTFieldAngle

1. Confirm the Diagnosis

Pressure is only one part. OCT, visual fields, gonioscopy and optic nerve appearance decide risk.

2. Micro-Stent Planning

iStent inject W or Hydrus-style MIGS can improve drainage in carefully selected eyes.

3. Protect Remaining Vision

Follow-up tracks IOP, fields and OCT so treatment is adjusted before silent loss progresses.

Understanding Glaucoma

The Silent Thief of Sight

Glaucoma is a group of eye conditions that damage the optic nerve — the critical connection between your eye and your brain. Often called the "silent thief of sight," it progresses slowly, without pain or symptoms, until significant and irreversible vision loss has already occurred.

Raised intraocular pressure (IOP) is an important and treatable risk factor, but it is not the only diagnostic factor. Some patients develop glaucoma at statistically normal pressures, while others have high pressure without nerve damage. A proper diagnosis combines IOP, optic nerve appearance, OCT retinal nerve fibre layer analysis, visual field testing, corneal thickness and risk profile.

India carries one of the world's heaviest glaucoma burdens. Over 12 million Indians are estimated to have glaucoma, yet more than half remain undiagnosed — often until damage is irreversible. Early detection and effective IOP control are the only way to preserve sight.

12M+

Glaucoma patients in India — one of the highest in the world

50%

Remain undiagnosed until significant vision loss has occurred

Leading cause of irreversible blindness globally after cataracts

Vision lost to glaucoma can be recovered — prevention is everything

The Procedure

What is MIGS?

MIGS — Minimally Invasive Glaucoma Surgery — is the most significant advance in glaucoma treatment in a generation. Instead of the large incisions and tissue disruption associated with traditional glaucoma surgeries, MIGS uses microscopic instruments through incisions under 2mm to restore or augment the eye's natural drainage pathways.

A tiny channel, micro-stent, or trabecular bypass device is precisely placed under gonioscopic visualisation — real-time microscopic guidance — to reduce intraocular pressure without removing or permanently altering major eye tissue. The result is durable IOP reduction with a dramatically lower risk profile than conventional surgery.

No large incisions — micro-entry under 2mm, same as cataract surgery

Minimal tissue trauma — preserves conjunctiva for future surgical options

Rapid 24–48 hour recovery — most patients resume normal activities next day

Topical anaesthesia only — eye drops, no injection near the eye

15–20 minute procedure — compact, efficient surgical time

Often combined with cataract surgery — treat both conditions in one visit

MIGS at a Glance

A transformative approach that makes advanced glaucoma treatment accessible, safe, and effective — even for patients who would otherwise simply manage with eye drops indefinitely.

<2mm

Maximum incision size

15–20

Minutes procedure time

24hr

Recovery to daily activities

Stitches required

Evidence-Based Comparison

Why MIGS vs Traditional Surgery?

The clinical evidence is clear — for mild-to-moderate glaucoma, especially when combined with cataract surgery, MIGS delivers superior outcomes with a vastly better safety profile.

Traditional Trabeculectomy

Conventional Approach

Incision SizeLarge (3–4mm)

AnaesthesiaInjection or General

Recovery4–6 weeks

Complication RiskSignificantly Higher

Bleb FormationRequired (risk of infection)

ConjunctivaPermanently altered

Best Suited ForAdvanced/refractory glaucoma

MIGS at BMH Chandigarh

Modern Precision Approach

Incision SizeMicro (<2mm)

AnaesthesiaTopical drops only

Recovery24–48 hours

Complication RiskSignificantly Lower

Bleb FormationNot required

ConjunctivaFully preserved

Best Suited ForMild–moderate + cataract

Why BMH Chandigarh

Why Choose BMH Chandigarh for MIGS?

The MIGS Journey

The Procedure: Step by Step

From your first consultation to long-term clear vision — here's exactly what to expect at every stage.

Pre-operative Assessment

A comprehensive glaucoma work-up: visual field testing, OCT optic nerve head analysis, gonioscopy to assess the drainage angle, corneal topography, pachymetry, and 24-hour IOP diurnal curve measurement. This data determines whether you're a MIGS candidate and which device/approach is optimal for your anatomy.

Day of Surgery

No general anaesthesia, no overnight stay, no fasting required. Anaesthetic eye drops are instilled 20 minutes before surgery. The procedure takes 15–20 minutes per eye. You will be awake and comfortable throughout. A driver is recommended, but you can eat and drink normally beforehand.

Micro-Incision Entry

A precision incision smaller than 2mm — identical to a cataract surgery incision — is made at the corneal margin. This self-sealing entry is the same size as the tip of a ballpoint pen. No sutures are needed, and the incision heals naturally within hours.

Gonioscopic MIGS Device Placement

Under the microscope with a specialised gonioscopic lens providing real-time visualisation of the drainage angle, the MIGS device or micro-channel is precisely placed into the trabecular meshwork or Schlemm's canal. This restores the eye's natural aqueous drainage, reducing IOP immediately.

Recovery & Follow-up Protocol

Day 1 review (IOP check, wound assessment), Week 1 (visual acuity and IOP confirmation), Month 1 (medication adjustment if needed), Month 3 (stability assessment), Month 6 (long-term IOP target review). Your drops may be reduced or eliminated based on your IOP response at each visit.

Patient Selection

Who is MIGS Right For?

MIGS is not one-size-fits-all — Dr. Baweja conducts a thorough pre-surgical assessment to identify the best candidates for optimal outcomes.

Mild–Moderate Open-Angle Glaucoma

The primary MIGS indication — patients with early to moderate disease who need better IOP control than drops alone provide.

Concurrent Cataract Surgery

The ideal combined case — MIGS is performed through the same cataract incision, treating both conditions in a single 20-minute session.

Intolerant of Eye Drops

Patients with surface irritation, allergy to preservatives, or compliance difficulties benefit from surgical IOP control.

Early Glaucoma Intervention

Before trabeculectomy becomes necessary — MIGS at the right stage can prevent progression and preserve all surgical options for the future.

Wanting to Reduce Drop Burden

Multiple eye drops are costly, time-consuming, and have systemic side effects. MIGS can dramatically reduce or eliminate the drop regimen.

Failed Medical Therapy

When maximum-tolerated medical therapy is insufficient to achieve target IOP, MIGS provides a safe next-step before more invasive filtration surgery.

Expert Care

Meet Your Surgeon

Dr. Varun Baweja

MBBS, MS (Ophthalmology) · NHS Fellow, United Kingdom · Ophthalmic & Refractive Surgeon

Trained in the United Kingdom's National Health Service — where MIGS is established standard-of-care protocol — Dr. Baweja brought this transformative technology to the Chandigarh region. His precision surgical technique, combined with a genuinely patient-first philosophy, has delivered sight-preserving outcomes for hundreds of glaucoma patients across North India.

Dr. Baweja's training encompassed the full MIGS device portfolio and gonioscopic surgery techniques used at leading NHS teaching hospitals, where volume and precision benchmarks are among the highest in the world. Each MIGS patient undergoes a rigorous pre-operative evaluation to ensure the right procedure, the right device, and the right timing.

NHS Fellow, UK MS Ophthalmology MIGS Specialist Refractive Surgeon Glaucoma Expert Est. 2022

Common Questions

Frequently Asked Questions

Answers to the questions our glaucoma patients ask most often before choosing MIGS at BMH.

What is MIGS and how is it different from traditional glaucoma surgery?

MIGS (Minimally Invasive Glaucoma Surgery) uses microscopic instruments through an incision under 2mm to enhance the eye's natural drainage pathways and reduce intraocular pressure. Traditional trabeculectomy requires a 3–4mm incision, creates an artificial drainage bleb under the eyelid, carries significantly higher complication rates including infection, hypotony, and bleb failure, and requires 4–6 weeks recovery. MIGS achieves comparable IOP reduction for mild-to-moderate glaucoma with far less disruption, faster recovery, and a markedly better safety profile.

Is MIGS surgery painful?

MIGS is performed under topical anaesthesia — numbing eye drops only. There are no injections near or around the eye. Patients are awake throughout but feel no pain; at most, a mild pressure sensation during instrumentation. Post-operatively, mild grittiness or irritation is normal for 24–48 hours and resolves spontaneously. Most patients are surprised at how comfortable the experience is compared to their expectations.

How long does MIGS surgery last?

The MIGS procedure itself takes approximately 15–20 minutes per eye. When combined with cataract surgery, total operating time is typically 25–30 minutes. Preparation and discharge together mean most patients spend 2–3 hours at the hospital on the day of surgery. There is no need for an overnight stay.

Can MIGS be combined with cataract surgery?

Yes — this is one of the most compelling advantages of MIGS. Because MIGS uses the same micro-incision as cataract surgery (under 2mm), both procedures can be performed in a single session without additional incisions, anaesthesia, or recovery. This is the standard approach at BMH for patients who have both conditions — treating cataract and controlling glaucoma simultaneously, maximising the benefit of a single surgical episode.

Will I still need eye drops after MIGS?

This depends on your individual IOP response after surgery. Many patients achieve their target IOP with significantly fewer drops — some can eliminate one or more medications entirely. A smaller proportion may achieve complete medication independence. Dr. Baweja personalises your post-operative drop regimen at each follow-up visit based on your actual IOP measurements. The goal is always to achieve the lowest safe IOP with the least medication burden.

How do I know if I'm a candidate for MIGS?

The key criteria are: mild-to-moderate open-angle glaucoma (not advanced or closed-angle disease), adequate drainage angle anatomy on gonioscopy, and either inadequate IOP control on drops, intolerance of drops, or concurrent cataract surgery. A formal candidacy assessment at BMH takes approximately 60 minutes and includes all necessary imaging and measurements. The assessment is not a commitment to surgery — it is information-gathering to plan the best management for your individual situation.

What is the recovery like after MIGS?

Recovery is dramatically faster than traditional glaucoma surgery. Most patients return to light daily activities within 24–48 hours. Driving is typically resumed in 1–2 days once confirmed safe at your Day 1 review. Swimming and contact sports should be avoided for 2–3 weeks. You will use antibiotic and anti-inflammatory drops for 4 weeks post-surgery, and attend scheduled follow-up appointments at Day 1, Week 1, and Months 1, 3, and 6.

Is MIGS covered by insurance at BMH?

MIGS coverage varies by policy and insurer. BMH works with Private insurance documentation support and transparent billing. When MIGS is performed in combination with cataract surgery, coverage is generally available under standard surgical benefit clauses. Our dedicated insurance desk will verify your specific coverage before the procedure and handle all documentation. We recommend calling us on +91-6280048805 to discuss your particular policy.

Take Action Today

Don't wait until vision is lost.
Book your MIGS consultation today.

Glaucoma damage is permanent and irreversible — but with timely MIGS, vision can be preserved for life. Our team is ready to evaluate you, answer every question, and create a personalised treatment plan.

Call +91-6280048805

MIGS Glaucoma Surgery —The Revolution Starts Here

How Glaucoma Steals Vision Silently