Navigating a new direction in micro-invasive glaucoma surgery: results from the COMPASS trial

Recent innovations and technological advances have ushered in a new era of surgical approaches to glaucoma management. Our options have expanded beyond traditional incisional glaucoma surgery (i.e., trabeculectomy and tube shunts) to include newer procedures that can be implemented earlier in patients with milder disease. Many of these recently introduced operations can be classified as micro-invasive glaucoma surgery (MIGS), for which five defining criteria have been proposed: an ab interno approach; minimal tissue trauma; at least modest efficacy; high safety; and rapid recovery (1). Candidates for currently available MIGS are generally those with early glaucoma whose disease does not require very low intraocular pressure (IOP) to retard progression and/or who may benefit from reduction in medical therapy.