Open angle glaucoma is typically due to structural changes within the trabecular meshwork, whether this be due to blockage with foreign material, loss of trabecular endothelial cell loss, or reduced pore size of Schlemm's canal (among other causes). MIGS is useful for addressing these issues. Closed angle however increases IOP by blocking the angle in the anterior chamber (and thus access to Schlemm's canal). Aqueous flowing from the posterior chamber to the anterior encounters increased resistance in passing through the iris-lens channel. The increase in pressure gradient between chambers causes the iris to bow head and obstruct the angle. This is not something MIGS can address as raised IOP in ACG is not due to Schlemm's canal pathology.
You're on the right track 007
EYE Summary (August 2024): Incredibly Undervalued, page-82
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