Minimally Invasive Glaucoma Surgery (MIGS)

MIGS is a newer development that has been shown to reduce complications in standard glaucoma surgeries.

MIGS, a widely accepted approach for treating mild-to-moderate glaucoma, is recognized for its many benefits. In particular, reducing discomfort and promoting quicker recovery.

Overall, MIGS surgeries are believed to be safer than traditional trabeculectomy or tube shunt surgeries.

According to recent medical studies, MIGS is an effective treatment to lower eye pressure without medication or the risks of traditional glaucoma surgery.

MIGS surgeries are grouped into several categories:

  • Miniaturized versions of trabeculectomy/tube shunt
  • Trabecular bypass operations
  • Totally internal or suprachoroidal shunts
  • Milder, gentler versions of laser photocoagulation


The iStent is a one-millimeter titanium tube that is inserted into the natural drainage channel of the eye. It aims to bypass blockages in the drainage channel and improve the flow of fluid out of the eye and reduce eye pressure. It is common to have two or maybe even three iStent devices implanted into the eye at the time of surgery.


The Hydrus, made of nickel and aluminum, is an eyelash-sized device that is put into the main drainage channel of the eye, the Schlemm’s Canal. The Hydrus acts as a scaffold to hold the drainage channel open and allow fluid in the eye to drain, reducing eye pressure.


Ab-interno Canaloplasty with iTrack is a type of surgery that cleans out the main drainage channel in the eye. Ab-interno refers to the direction from which the main drainage channel is accessed during surgery, the front of the eye. The iTrack is a tiny catheter that is inserted into the drainage channel. A special gel is then injected through the catheter, opening up the drainage channel and removing any blockages. Fluid is then able to flow out of the eye, reducing eye pressure.


Cyclophotocoagulation (CPC) uses a laser probe that targets the ciliary body, the part of the eye responsible for creating fluid. The laser reduces the activity of the ciliary body, inhibiting the production of fluid and in turn reducing eye pressure. CPC is an incision free surgery.


The Xen gel stent is a 6-mm hydrophilic flexible tube made of porcine collagen-derived gelatin cross-linked with glutaraldehyde, which is non¬inflammatory and causes minimal extraocular fibrotic or vascular response to the implant material. The Xen decreases eye pressure by creating a permanent drainage shunt from the anterior chamber to the subconjunctival space through a scleral channel. The device hydrates within 1-2 minutes of contact with aqueous humor, bending and conforming to tissue. This flexibility mitigates many of the issues seen with synthetic materials such as migration, erosion and corneal endothelial damage.


GATT (Gonioscopy-Assisted Transluminal Trabeculotomy) is a minimally invasive surgical treatment for the management of glaucoma and is a modification of a glaucoma surgery (trabeculotomy) that has been around for over 50 years. Trabeculotomy has a proven history of being safe and effective for the treatment of glaucoma.


The bimatoprost implant, Durysta, was approved by the Food and Drug Administration on March 5th, 2020 for reduction of eye pressure in patients with open-angle glaucoma or ocular hypertension (OHTN). The implant is the first sustained release therapy to be approved for this purpose.

What Our Patients Are Saying

My appointments were long, but you explained what was going on and I appreciate your taking the time to help me understand my options. I feel good that I made the right choices and also about my vision. I think it is in good care with you. Thank you very much.


I was impressed by the professionalism of the office staff from check in to exams to checkout. At my cataract surgeries I felt safe and secure in their procedures. Dr Spaulding performed my surgeries and I would recommend him to anyone needing the services he offers. He was both personable and professional.


A Rewarding Experience, Between Veteran's Affairs, Tri West Healthcare Alliance and Cataract & Laser Institute. Dr. Christopher Jovez, O.D, of the VA, arranged through Tri West Health Care Alliance, for me to meet Dr. Tina Rutar, M.D. of Cataract & Laser Institute for Cataract and Strabismus surgery. Both procedures were performed sucessfully in a timely and professional manner with great results. I am greatly pleased with Dr. Rutar and her team and employees at C & L Institute and their professionalism.

RobertArmy Veteran

This place is filled with staff who values everyone who walks into their office. They take their time to show every patient the same level of excellence care and service. As response to the negative comments, I for one don't want anyone rushing to get me out the door, without full proper correction of what ever brought me in to their office. The office management, Janice and Paula have always been friendly and make sure that they have had great staff to provide only the best.


I can't rave enough about the amazing Dr. Rutar. I deeply respect and admire her skill and knowledge. I had strabismus (eye muscle) surgery done by Dr. Rutar February 2018. I'm 32 and my left eye has been "lazy" my whole life, due to an underdeveloped muscle. More than a year later, my eyes are still aligned. The incisions healed beautifully and my depth perception is spot on. You'd never know what my eyes have been though and I'll be scheduling an appointment for contacts soon. If you're considering this surgery, as scary may seem, I urge you to push through that fear. It was well worth it. My life has changed for the better because of it. Telling Dr. Rutar, "thank you" - will never be enough.


I had a great experience here. I was greeted promptly and treated courteously. Dr Spaulding and his staff were amazing. The length of my visit was to be expected for visiting a doctors office. I would not change a thing with the experience. Thank you!!!


The entire experience was impressive! The prep nurses were great and the surgery was not a problem because I was put under and can’t remember anything.???? Dr. Spaulding did a great job! I’m very thankful and Blessed to have my sight back.


I could not be more pleased by the treatment I received from Dr. Rutar and her staff. She performed two cataract surgeries for me and each time she carefully explained all the options and risks along with the likely outcomes. I was completely confident in her approach, as well as in her staff, who are very pleasant and professional.


It is easier for me to find a Ruby than a doctor like Tina. She loves her job and her patients.


The level of professionalism, kindness and care given to me before, during and after my Cataract surgery was excellent. Given the public's concern over the C-virus every preventative measure of protection was taken. The prep and recovery nurses made sure I was comfortable & remained calm before and following the surgery. Dr. Spaulding’s surgery technique is perfection.


1 one of the most professional office i seen. Very clean. Appointment on time. Staff very nice.

ECB Klamath

Dr. Rutar has a kind, gentle, positive manner in which she cares for my condition. She is honest & thorough. Thank you!


I’ve purchased two pairs of prescription Oakleys from the optical shop here, one sunglasses and the other progressives. They had an excellent selection of both high-end and budget frames and Gary and Jenny were very helpful in choosing and fitting the frames. Both sets of glasses turned out great—amazingly clear and comfortable! Highly recommended!


Dr. Rutar, you and your staff need to know that you could easily become the model of how your type of center should be run. There is such a strong feeling of caring from the staff, to the examination, to the nurses, and of course, to you Dr. Rutar.

One of the key attributes about your is that you always tell your patient what you are doing before you do it. I like that. I sure appreciate your working with me on various key points.

I know this world is a better place having you as a physician. I appreciate you and all your hard work and dedication to your patients.


Had debris in my eyes. Didn't think I flushed it all out. They got me in within a couple hours of calling and checked my eyes out for me. Very Professional and friendly staff. Highly recommend them. Thank you Dr. Barrus 🙂


I love Dr. Rutar and her whole crew of helpers. I was so nervous about having the 2 eye surgeries, but the surgery girls were so nice, helpful & encouraging, and made me feel at ease!

Dr. Rampton (anesthesiologist) explained what he was going to do.

I went through both surgeries and tests and I would refer everyone I know to come to Cataract & Laser!

Thank you for your care.


Other than some billing issues I am more than pleased with my results. Dr. Rutar made the experience safe and easy. Thank you.


I was very impressed with Dr Rutar. She immediately ordered the proper blood tests to diagnose my rare disease. It was missed by other physicians for over 5 years. It's great to finally know!


Terry and Wendy (in the surgery center) were WONDERFUL, PROFESSIONAL, and explained everything to me. They are amazing at what they do. I highly recommend the office. It is a caring environment with friendly staff. My first surgery was done at another location and they did not give me discharge instructions. Here they not only gave me the instructions, but took the time to explain it all to me. Thank you again for a great experience!!!