[Modern methods of minimally invasive glaucoma surgery].

Over the years, glaucoma surgery has improved from iridectomy by A. Graefe and traumatizing procedures performed without magnification tools or microsurgical instrument to high-technology interventions that are not only microscopic, but also pathogenetically oriented. Various modifications of trabeculectomy, initially introduced by J. Cairns back in 1968, had been the gold standard for several decades and were notable for pronounced and stable hypotensive effects. However, there was also a strong association with such complications as choroidal detachment and hyphema, thus, boosting the development of so called nonfistulizing surgeries. Of the latter, the most widely used are non-penetrating procedures, including deep sclerectomy and viscocanalostomy. Although very safe, they appear unable to produce a truly long-lasting hypotensive effect. Moreover, just as fistulizing trabeculectomy, non-penetrating procedures damage the limbus and adjacent conjunctiva reducing the possibility of a second intervention. This fact together with other drawbacks mentioned above, on the one hand, and technical progress, on the other, were essential prerequisites for the appearance of a new type of surgery - minimally invasive glaucoma surgery (MIGS). Parameters that should be met for a procedure to be considered minimally invasive are debated. The main requirement has, however, been established: ab interno approach through a corneal incision. As surgical tools are enhanced and new techniques arise, options for glaucoma treatment widen greatly, ensuring our future move to higher level standards in the field. This review contains all recent data on minimally invasive techniques currently in use in glaucoma surgery or those under investigation. The authors have also analyzed effectiveness reports and present their conclusions regarding the current state of MIGS worldwide.