Evolving Role of MIGS in the Combined Management of Cataract and Primary Open-Angle Glaucoma

Abstract

Background: Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness globally. Its coexistence with cataract is common in the aging population. Minimally invasive glaucoma surgeries (MIGS) have emerged as safer,conjunctiva-sparing alternatives to traditional filtering procedures, offering modest IOP reduction with fewer complications and faster recovery. These procedures are especially appealing in cases with concurrent visually significant cataract, where they can be combined with phacoemulsification in a single session. This review aims to provide an updated, comparative overview of MIGS procedures applicable in coexisting cataract and POAG, focusing on the mechanisms of action, surgical techniques, and device-specific outcomes. It also highlights the role of combined surgeries, including BANG (Bent Ab Interno Needle Goniectomy), in current clinical practice and discusses the expanding indications of MIGS in different stages of glaucoma.