Purpose: Evaluation of Deep Sclerectomy(DS) in treating open angle
glaucoma.
Methods : A prospective study of 63 consecutive eyes undergoing DS or
phaco DS over a 12 month period was performed. The technique of DS is to deroof
Schlemm’s Canal and create a trabeculo-descemetic membrane allowing aqueous
filtration into an intra-scleral lake. 32 eyes underwent phaco DS and 31 eyes
DS alone. In 6 eyes at risk of failure due to previous limbal surgery, per
operative 5FU or Mitomycin C (MMC) 0.04% were used. Mean follow-up was 18
months (range 12 months to 24 months)
Results : The mean
pre-operative IOP was 27.6 mmHg (range 15 to 45) on an average of 2.1
medications. The mean post-operative IOP at 18 months follow-up was 15 mmHg
(range 6 to 24) on an average of 0.05 medications. Visual acuity was unchanged
in DS cases and improved in 96% of phaco DS cases.
Complications: 1 wound leak associated with MMC, 1 iris prolapse with
pressure spike, 6 post op steroid induced pressure spikes. There were no cases
of flat or shallow anterior chamber. 4 eyes required YAG laser goniopuncture.
Conclusions: DS and phaco DS are effective surgical procedures for
treatment of glaucoma and glaucoma with cataract.