Deep Sclerectomy
Deep sclerectomy is a less invasive techniques than conventional filtering surgery (trabeculectomy) that leave the anterior chamber (front of the eye) intact and avoid creation of blebs.
In deep sclerectomy, the surgeon removes a deep piece of the sclera (the white part of the eye), part of the trabecular meshwork, and the front of Schlemm's canal (the vessels that return fluid into the bloodstream).
- In deep sclerectomy, the surgeon first creates a flap in the outer part of the sclera (the white part of the eye) and then removes a deep piece of the sclera underneath. This opens up Schlemm's canal (the vessels that return fluid into the bloodstream) and exposes a layer above the anterior chamber called Descemet's membrane. A space has also been created between the inner and outer layers of the sclera.
- In deep sclerectomy, this space now serves as a tiny reservoir for aqueous fluid that flows through the membrane and pools here. The fluid then flows out without the surgeon having to open the anterior chamber (as in standard filtering surgery).
Many variations are under investigation. In general, the procedures have fewer complications afterward than standard filtering surgery, although they require excellent surgical skill. Nonpenetrating techniques do not lower IOPs as much as conventional surgery does, however. In good hands and for the right indication, however, these nonpenetrating techniques are expected to be as effective as filtration surgery.
Cataract Surgery maybe combined with glaucoma fitration surgery. A combined micro-incision cataract operation done with a deep slerectomy is seen in the following video:
This page was last modified on Friday, March 06, 2009