Deep sclerectomy with a collagen implant using the excimer laser

• Published in: Journal of cataract and refractive surgery Vol. 27; no. 4; pp. 504 - 506
• Main Authors: Argento, Carlos, Sanseau, Ana C, Badoza, Daniel, Casiraghi, Javier
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2001; Elsevier Science
• Subjects: Aqueous Humor - metabolism; Biological and medical sciences; Collagen; Glaucoma - surgery; Humans; Intraocular Pressure; Laser Therapy - methods; Medical sciences; Prostheses and Implants; Prosthesis Implantation; Sclera - surgery; Sclerostomy - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Human; Implant; Aqueous humor; Isolated organ; Drainage; Eye; Eye disease; Treatment; Glaucoma (eye); Surgery; Collagen; Excimer; Laser; Sclerotomy; Anterior chamber; Technique; Descemet membrane; Sclera
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/S0886-3350(00)00609-X

We describe a new technique of nonpenetrating glaucoma surgery that uses the excimer laser to reduce the risk of perforating the trabeculo–Descemet’s membrane. With this technique, the ablation is precise and homogeneous. A collagen device is sutured over the scleral bed to create an outflow pathway for aqueous humor drainage. After a superficial scleral flap is dissected with a diamond knife, the sclera, under direct visualization, is ablated with the excimer laser over Schlemm’s canal until aqueous humor percolates through from the anterior chamber. A collagen device is placed over the sclera to allow the aqueous humor to flow from the anterior chamber through the trabeculo–Descemet’s membrane. The preliminary results show a drop in intraocular pressure to the middle teens.