ABSTRACT

However, the IOP outcome of deep sclerectomy can be greatly improved if the procedure is transformed into a penetrating one by means of an opening of the filtering membrane via YAG-laser goniopuncture. Two long-term case series have been reported by Mermoud’s group in Lausanne.The first case series10 reports results collected in 105 glaucomatous eyes offered a deep sclerectomy with collagen implant (DSCI).The cohort was followed for up to 5 years. At the end of follow-up, 65 eyes (61%) showed an untreated IOP <21 mm Hg. Out of these 65, 29 had YAG-laser goniopuncture performed during follow-up because of an uncontrolled IOP. Therefore, the percentage of the study population ending with an IOP <21 mm Hg due to an actual non-penetrating procedure, dropped to 34%. However, it is noteworthy to point out that 45.7% of the overall population (including both the goniopunctured and the nongoniopunctured eyes) ended the study with an untreated IOP <16 mm Hg.The authors do not provide information allowing us to identify among this subgroup those eyes which had the non-penetrating surgery transformed by laser into a penetrating one. Nevertheless, a 5-year 45.7% success rate, with <16 mm Hg as a cut-off, is a figure comparable to that reported for trabeculectomy.