Treatment Overview
Korean MIGS Combo Surgery refers to the highly advanced, multi-technique approach used in Korea to treat glaucoma by combining two or more Minimally Invasive Glaucoma Surgery (MIGS) procedures in a single session. This synergistic strategy targets multiple outflow pathways—trabecular, canal-based, suprachoroidal, or subconjunctival—to achieve superior intraocular pressure (IOP) reduction compared to a single MIGS technique.
Korean ophthalmology centers are global leaders in MIGS combination therapy due to their integration of:
- AI-assisted MIGS pairing algorithms
- OCT-guided angle and canal imaging
- Digital surgical tracking systems
- Femtosecond-assisted cataract surgery integration
- High-definition gonioscopy and micro-incision access
These innovations allow Korean surgeons to tailor each combination to the patient’s anatomy, glaucoma severity, and medication burden—resulting in highly predictable outcomes and excellent long-term safety.
Purpose & Benefits
Purpose
- Provide enhanced IOP reduction by targeting multiple outflow pathways.
- Reduce or eliminate dependence on glaucoma medications.
- Address multifactorial outflow resistance in mild to moderate glaucoma.
- Improve long-term stability and reduce the need for future surgeries.
- Complement cataract surgery for a strong combined effect.
Benefits
- Dual or Triple-Mechanism Action: Restores outflow through multiple drainage routes.
- Greater IOP Reduction: More effective than single MIGS procedures.
- Lower Medication Burden: Many patients significantly reduce or discontinue drops.
- Minimally Invasive, Low Trauma: Small incisions and rapid healing.
- High Customization: Procedures tailored to canal architecture, TM resistance, and glaucoma severity.
- Long-Term Stability: Enhanced durability when multiple pathways are opened.
Common Korean MIGS Combination Options
Korean surgeons select the combination based on individual anatomical needs, glaucoma type, and desired IOP target.
1. Trabecular + Canal-Based Combination
Examples:
- KDB Glide + Canaloplasty
- iStent Inject W + Healon-assisted Canaloplasty
- ELT + Goniotomy
Best for: Early to moderate open-angle glaucoma
Goal: Improve both TM bypass and canal dilation
2. Trabecular + Subconjunctival Combination
Examples:
- KDB + Xen Gel Stent
- iStent + Filtration MIGS
Best for: Moderate glaucoma needing more significant IOP reduction
Goal: Combine physiological outflow with enhanced filtration
3. Canal-Based + Suprachoroidal Combination
Examples:
- Canaloplasty + Suprachoroidal Microstent
- GATT + Suprachoroidal MIGS
Best for: Eyes with higher outflow resistance beyond Schlemm’s canal
Goal: Utilize an additional drainage route for enhanced IOP reduction
4. Triple MIGS Combination
Examples:
- KDB Glide + iStent Inject W + Canaloplasty
- GSL + Goniotomy + Canaloplasty
Best for: Complex or mixed-mechanism glaucoma
Goal: Maximum IOP lowering while remaining minimally invasive
Ideal Candidates
Korean MIGS Combo Surgery is ideal for:
- Patients with mild to moderate open-angle glaucoma.
- Individuals undergoing combined cataract + MIGS procedures.
- Patients who need greater IOP reduction than single MIGS can offer.
- Individuals intolerant to glaucoma medications.
- Patients with multi-level outflow resistance (TM, canal, collector channels).
- Those aiming to reduce long-term treatment burden.
Possible Risks & Complications
Although highly safe, combining MIGS procedures may slightly increase minor postoperative effects:
- Temporary hyphema (small blood reflux)
- Mild inflammation
- Short-term blurred vision
- Early IOP fluctuations
- Rare stent malposition (if implants are used)
Korean surgeons minimize risks using:
- AI-assisted combination planning
- OCT-guided surgical execution
- Ultrasmooth micro-incision techniques
- Enhanced postoperative monitoring protocols
Surgical Techniques
AI-Based MIGS Planning System
Predicts ideal combinations for patient anatomy and glaucoma severity.
High-Definition Gonioscopy
Supports precise angle targeting for multiple procedures.
OCT-Guided Canal and TM Imaging
Ensures accurate selection of canal segments and TM excision points.
Micro-Incision Multi-Access
Allows multiple MIGS tools to be inserted through small corneal entry points.
Sequential or Simultaneous Treatment
Depending on the combination, MIGS may be performed in carefully timed sequence or concurrently.
Femtosecond Laser Integration (When Combined with Cataract Surgery)
Enhances surgical precision for MIGS + cataract combo cases.
Treatment Process in Korea
Step-by-Step Workflow
Step 1 – Comprehensive Glaucoma Assessment
Includes OCT, gonioscopy, TM mapping, canal imaging, visual fields, and AI prediction models.
Step 2 – MIGS Combination Selection
Surgeon selects two or three MIGS options for optimal IOP reduction.
Step 3 – Micro-Incision Entry
Tiny corneal incisions allow simultaneous angle and canal access.
Step 4 – Combined MIGS Execution
Procedures are performed in sequence (e.g., TM removal + canal dilation + stent implantation).
Step 5 – Postoperative Monitoring
Follow-up reviews track canal flow, stent placement (if applicable), and long-term IOP control.
Treatment Duration: 15–25 minutes (standalone) or 25–40 minutes with cataract surgery
Setting: Outpatient, same-day discharge
Recovery & After-Care
After-Care Guidelines
- Use anti-inflammatory and antibiotic drops for 2–4 weeks.
- Avoid heavy exercise, swimming, and eye rubbing for several days.
- Wear protective sunglasses outdoors.
- Continue medications only if instructed; most are reduced.
- Attend follow-ups at Day 1, Week 1, Month 1, and Month 3.
Recovery Timeline
Days 1–3: Mild redness or blood reflux; early IOP changes begin.
Week 1: Improved vision; drainage pathways stabilize.
Weeks 2–4: Strong IOP reduction; medication tapering begins.
1–3 Months: Full recovery with stable multi-pathway outflow.
Results & Longevity
Expected Results
- Significant IOP reduction greater than single MIGS alone.
- Enhanced long-term stability by opening multiple drainage routes.
- Reduced medication dependence for most patients.
- Faster recovery compared to traditional glaucoma surgeries.
Longevity
- Results often last many years, depending on glaucoma severity.
- Combining MIGS decreases scarring risk and prolongs canal functionality.
- Additional MIGS or laser procedures can reinforce long-term outcomes if needed.
Why Korea Is a Top Destination
- World-leading MIGS expertise with thousands of successful combination surgeries.
- AI-enhanced personalized surgical planning for optimal combinations.
- Top-tier imaging systems (OCT, Scheimpflug, 3D gonioscopy).
- Advanced technology integration with femtosecond cataract systems.
- Outstanding surgical outcomes with rapid recovery and stable long-term IOP control.
Unique Korean Innovations
- AI-powered MIGS pairing algorithms.
- High-resolution canal and collector channel mapping.
- Hybrid MIGS protocols tailored to glaucoma stage.
- Digital surgical tracking for stent and canal accuracy.
- Multi-pathway outflow optimization using machine-learning models.
These innovations make Korean MIGS Combo Surgery one of the most advanced, customizable, and effective glaucoma treatment options globally.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Dual-MIGS Combo | ₩3,000,000 – ₩5,000,000 | ~$2,300 – $3,800 | Two MIGS procedures with basic imaging |
| Premium Triple-MIGS Package | ₩5,500,000 – ₩8,500,000 | ~$4,100 – $6,500 | OCT-guided triple MIGS with AI planning |
| Hybrid Cataract + MIGS Combo Program | ₩6,000,000 – ₩10,000,000+ | ~$4,500 – $7,600+ | Combined cataract + dual or triple MIGS |
Pricing varies based on MIGS types, technology level, and surgeon expertise.
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul): Leaders in customized MIGS combination treatments.
- Dream Eye Center (Seoul): Known for OCT-guided multi-MIGS precision surgery.
- BGN Eye Clinic (Seoul & Busan): Experts in MIGS + cataract hybrid procedures.
- Glory Seoul Eye Clinic: Specializes in advanced multi-pathway MIGS combinations.
- K-Cure Vision Center (Gangnam): Pioneers in AI-optimized MIGS planning.
