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  • Writer's pictureAtanas Bogoev M.D.

ESCRS MIGS Masterclass 2023: A New Course on Microinvasive Glaucoma Surgical Training

This year for the first time the European Cataract and Refractive Surgery Society (ESCRS) announced a new microinvasive glaucoma surgical training course - the ESCRS MIGS Masterclass 2023. If you want to know what it consists of and if it's worth applying for, read on. During the ESCRS Congress in Vienna, I (Atanas Bogoev, MD) had the opportunity to go through it, and I am here to share all about it from my personal experience.

It is well known that glaucoma is one of the most common causes of irreversible blindness, affecting millions of people globally. Treating glaucoma can be challenging, especially in complex cases, where conventional medical treatment (eyedrops) or laser therapy may not be sufficient. That's where MIGS comes in, helping us ophthalmologists efficiently treat patients with an innovative approach to glaucoma surgery.

MIGS training

In the last decade, there has been a growing interest and development in microinvasive glaucoma surgery (MIGS). It's a group of surgical procedures using micro-sized devices or techniques to enhance the aqueous humor drainage from the eye, with minimal trauma and complications.

An increasing number of recent publications demonstrate how MIGS proves to be effective and safe, especially in lowering the IOP and reducing the need for glaucoma medications in selected patients.

search query in PubMed
The graph is based on a search query in PubMed and shows that the number of MIGS publications has increased significantly over time, especially in the last decade.

Of course, MIGS is not a one-size-fits-all solution. It requires careful patient selection, surgical planning, proficient surgical technique, and follow-up.

MIGS is a rapidly evolving field, constantly introducing and improving on new devices and techniques. Therefore, it is essential for ophthalmologists who want to perform MIGS to acquire adequate knowledge and skills and keep up with the latest evidence and innovations.

To address this need, the European Society of Cataract and Refractive Surgeons (ESCRS) has launched a new course in 2023. It's called the ESCRS Masterclass on Microinvasive Glaucoma Surgical Training. The course provides practical training on MIGS targeting ophthalmology specialists with some glaucoma surgery experience and those who want to expand their expertise.

ESCRS MIGS Masterclass: How to apply

Application for the MIGS Masterclass 2023 started in May 2023.

To apply for the ESCRS Masterclass MIGS, first of all you need to meet the following criteria:

  • You are a member of the ESCRS

  • You have to have some experience doing surgery, preferably comfortable with cataract surgery

  • You have to have and show interest and be motivated to learn about MIGS

  • You are willing to commit time to the program and attend all online and in-person sessions, as well as the on-site course and Wetlabs

You apply by filling out an online application on the ESCRS website.

ESCRS MIGS Masterclass: Structure

The ESCRS MIGS Masterclass 2023 had two parts: an online part and an on-site part.

The online part included four modules that cover the basic principles, indications, contraindications, complications, and clinical outcomes of MIGS. Each module consisted of video lectures. It also included four live webinars, where we could interact with the faculty, ask questions, and participate in discussions. Some of the online modules include:

  1. Lectures from renowned glaucoma subspecialty experts on glaucoma overview;

  2. Therapeutic options and target intraocular pressure for glaucoma patients

  3. Visual fields and Optic nerve head imaging and interpretation

  4. Gonioscopy during the clinic and intraoperatively

  5. Anterior ocular segment anatomy

  6. Angle surgery with various specific MIGS devices, stents, and bleb-forming implants.

Lectures length is usually between 40 to 60 minutes. They were very concise, to the point, and packed with research, good practices, and helpful advice. The lectures were so informative that I even went through them one more time after completing the course. I find them very practical and extremely helpful for my daily work in the clinic!

Furthermore, the participants were invited to join a WhatsApp group, where they could discuss cases and share experiences with their peers and mentors. Questions from the WhatsApp group were discussed thoroughly during the webinars.

ESCRS MIGS Masterclass 2023: Mentors

When I talk about my experience with the ESCRS Masterclass, one of the first things that comes into my mind is the high quality of tailored mentorship from the incredible MIGS Faculty. You could feel the energy and the time the team of motivated, renowned experts in glaucoma surgery, put into organizing the course.

The faculty includes Ziad Khoueir (Program Chair, Lebanon), Leon Au (United Kingdom), Henny Beckers (Netherlands), Syril Dorairaj (USA), Karsten Klabe (Germany), Verena Prokosch (Germany), Andrew Tatham (United Kingdom). All of them are very down to earth, approachable, and are great teachers!

Panel of MIGS educators

ESCRS MIGS Masterclass 2023: On-site

The on-site part was a two-day intensive course at a state-of-the-art congress center in Vienna. The first day included several case discussions. We were split into groups of 8-10 participants and were assigned a mentor. We had to answer specific questions regarding a case of glaucoma as a group, which stimulated very interesting discussions internally. After the time for each case was up, each group had to present its therapeutic option and answers to the question and present them to the others, sparking even more interesting discussions between groups. In the afternoon we switched to doing various wet labs, and practical training on different MIGS devices and techniques:

  • iStent inject

  • Hydrus Microstent

  • iTrack surgical system

  • Kahook dual blade

  • ECP

After the busy day 1 we were invited to an official MIGS Masterclass dinner event, where the participants had the opportunity to network with each other and connect with the faculty. If you are accepted for the next MIGS masterclass you cannot miss this dinner! For me, it was one of the highlights of the course. You can easily approach and chat with fellow colleagues from around the world or ask the mentors whatever you like!

pictures from the ESCRS MIGS Masterclass 2023

We were divided into several groups of 8-10 participants and rotated through the Wetlabs. Each Wetlab was about 1 hour and 30 minutes and included an introduction lecture about the device, surgical technique and some tips and tricks.

Pictures from MIGS training course

After completing the Wetlabs on day 2 we had to take a 100-question multiple-choice question test, focused on what we learned.

I believe the ESCRS MIGS Masterclass provided us with a solid foundation and confidence in performing MIGS. The surgical training course also inspired us to pursue excellence and keep in touch with the innovation in the glaucoma field.

ESCRS MIGS Masterclass 2024

The ESCRS Masterclass 2024 will be open for applications in the spring of 2024. So stay tuned and do not miss the opportunity to apply! It is so worth it! For more information and registration, please visit the ESCRS official website.

Dr Atanas Bogoev at the ESCRS Vienna 2023 congress

Comment below for any questions! - Atanas Bogoev, MD, FEBO


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