BLEBS. SHALLOW CHAMBERS. Bleb leaks. Flat chambers. Dellen. Blebitis.
No bleb. Late failure. Hypotony. Choroidal effusions. Maculopathy. Is there
a better way? If the problem is in the meshwork, why do we cut a hole in the
eye?
Viscocanalostomy and deep sclerectomy are surgical procedures for glaucoma
that have been designed to avoid some of the complications of conventional
glaucoma surgery.1-2 The concept
of nonpenetrating glaucoma surgery was first introduced in 1962, and variations
have been described since then.3-4
Viscocanalostomy is reported to lower intraocular pressure (IOP) without creating
a filtering bleb.1 Deep sclerectomy, a nonperforating
filtration procedure, is reported to avoid shallow anterior chambers and the
other early postoperative problems of conventional filtering surgery and also
produce lower, more diffuse blebs.2, 5-7
Both procedures involve fashioning a partial-thickness scleral flap and then
removing a second layer of sclera deep to the initial flap. This unroofs Schlemm's
canal and exposes Descemet's . . . [Full Text of this Article]
AQUEOUS OUTFLOW
THE NORMAL EYE
Juxtacanalicular Tissue
Schlemm's Canal
THE GLAUCOMATOUS EYE
HOW DOES NONPENETRATING SURGERY WORK?
UNROOFING SCHLEMM'S CANAL
CREATION OF DESCEMET'S WINDOW
SCLERAL LAKE
INJECTION OF VISCOELASTIC MATERIAL
FUTURE GOALS
