Deep sclerectomy is a non-penetrating surgical procedure used for the treatment of open-angle glaucoma.

A less invasive technique than filtering surgery, deep sclerectomy leaves the anterior chamber (front of the eye) intact and avoids the creation of blebs (the tissue that forms a fluid reservoir over the surgically created hole in conventional glaucoma, trabeculectomy surgery).

In deep sclerectomy, the surgeon skims a patch of the sclera to a level upon which percolation of liquid from the inner eye is achieved and thus alleviating intraocular pressure, without penetrating the eye. Due to the non-penetrative nature of deep sclerectomy, the anterior chamber is left unscathed, thus reducing any post-operative inflammation which can be a symptom of iridectomy surgery which involves the removal of a portion of iris tissue.

Another benefit of deep sclerectomy is the slow decrease in the intraocular pressure during the surgical procedure, which helps prevent hypotony (low intraocular pressure).

 

How is the procedure performed?

A deep sclerectomy, also known as a viscocanalostomy, can be undertaken with a local anaesthetic or whilst asleep (under general anaesthetic).  The procedure takes in total approximately 20 minutes.  The white of your eye has a small trap door measuring about 4 mm gently dissected over the eye.  The drainage channel is exposed (Schlemm's Canal) and a gentle leakage of eye fluid occurs.  Stitches are used to close the wound.

After the operation, you will likely need to have a pad placed over the eye until you are comfortable taking this off.  You will be provided with eyedrops before you leave.  A review appointment will also be organised.

 

What are the benefits of a deep sclerectomy?

  • Non-penetrating procedure so less risks
  • Vastly reduced risk of vision threatening problems, such as endophthalmitis (infection inside the eye), choroidal haemorrhage (bleeding in the back of the eye as a result of low eye pressure) and low pressure (hypotony)
  • Quicker procedure, as less surgical time
  • Less time off work
  • Easier post operative management

 

What are the downsides to a deep sclerectomy?

  • Often the eye pressure is not as low as with a penetrating proedure such as trabeculectomy
  • On occasions, the operation does not work and may need repeating
  • It is possible that 'top up' eyedrops are needed to achieve a lower eye pressure
  • A deep sclerectomy may not last as long as a penetrating procedure

 

If you have been affected by any of the symptoms mentioned above, please don't hesitate to give us a call.

We have a team of experts on stand-by who are ready to take your call at our Manchester (0161 907 2685) Clinic or our Blackpool (01253 308 031) Clinic.