Minimally Invasive Glaucoma Surgery

Central Valley Eye Medical GroupGlaucoma is a sneaky eye disease. Invariably the patient doesn’t have any symptoms while the elevated pressure inside the eye is beginning to damage the optic nerve. The first signs are usually a loss of peripheral vision, and this is irreversible.

That’s why we constantly advise our Central Valley Eye Medical Group patients who are over 40 about the need to have yearly comprehensive eye exams. That’s where we can spot glaucoma before it begins to damage your vision.

Treatment usually begins with eyedrops that lower the intraocular eye pressure, but these don’t always work. The next step is usually one of a variety of surgeries to open blocked or insufficient drainage out of the eye. The problem with these surgeries is that they involve some risks and side effects. In an effort to avoid some of those, minimally invasive glaucoma surgeries (MIGS) are increasingly being used. Whenever possible, we employ MIGS techniques for our glaucoma surgeries at Central Valley Eye Medical Group.

Here’s some more information about MIGS. These procedures are divided into several categories:

  • Miniaturized versions of trabeculectomy
  • Trabecular bypass operations
  • Totally internal or suprachoroidal shunts
  • Milder, gentler versions of laser photocoagulation


These surgeries insert microscopic tubes into the eye to help drain fluid from inside the eye to the outer membrane of the eye. Two devices have recently been approved for use, the XenGel Stent and PRESERFLO, and seem to make the procedure safer.

Trabecular surgery

Most of the problems with fluid drainage come in the trabecular meshwork at the outer corners of the eyes. Several procedures use tiny equipment and devices to cut through the trabecular meshwork without damaging any other tissues in the ocular drainage pathway. The trabecular is either destroyed or bypassed. These procedures don’t usually dramatically lower eye pressure, but are effective for early to moderate stages of glaucoma.

Suprachoroidal shunts

Using tiny tubes with very small internal openings, the front of the eye is connected to the suprachoroidal space between the retina and the wall of the eye to augment the drainage of fluid from the eye.

New laser procedures

Earlier laser cyclophotocoagulation methods were used for advanced glaucoma that didn’t respond to trabecular surgeries or tube shunts. They sought to reduce the eye’s fluid-forming capacity. But they could produce severe inflammation that could reduce vision. Two new surgeries — endocyclophotocoagulation and micropulse cyclophotocoagulation — have proven useful even before the glaucoma has reached advanced stages.

At Central Valley Eye Medical Group we pride ourselves on staying at the forefront of vision technology. These MIGS are just the latest example of how we’re helping our patients cope with the evils of glaucoma.

Is it time for your next eye exam? If you’re over 40 you need to have one every year. Call us at Central Valley Eye Medical, (800) 244-9907, to schedule your appointment.

Posted in: Glaucoma


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Dear Friends,

We at Central Valley Eye hope that you and your families are well. To continue to protect the health of our patients and staff during the coronavirus pandemic, we are taking all reasonable precautions as we provide the eye care that our community needs:

  • All patients and staff must now wear masks within the clinic building. Please bring one from home.
  • Whenever appropriate, we are rescheduling patients with fever, cough, or cold symptoms
  • We have adjusted our schedule to decrease the number of patients in our waiting rooms
  • We have increased our already strict sanitizing practices
  • Whenever appropriate, we are diverting visits to telemedicine (by cell phone, tablet, laptop, or desktop). Please contact us for further details at 209-952-3700.

If you are unsure whether to come in for your visit, please call us.

Following state guidelines, the doctors at Central Valley Eye have recently resumed performing elective surgeries. Our surgery coordinators will be contacting patients to reschedule the surgeries that needed to be postponed. We appreciate your patience during this time.

If you have any questions, please do not hesitate to contact us at 209-952-3700.

Warmest regards,

Brandy Simpson
Practice Manager
Central Valley Eye Medical Group, Inc.