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Chapter-23 Trabeculotome-Guided Deep Sclerectomy

BOOK TITLE: Surgical Techniques in Ophthalmology: Glaucoma Surgery

Author
1. Abdelrahman Ahmed Mostafa
ISBN
9788184489583
DOI
10.5005/jp/books/11383_23
Edition
1/e
Publishing Year
2010
Pages
4
Author Affiliations
1. Cairo University, 8-Morad Street (Morad Tower), Apart 409, Giza, Egypt, Cairo University, 8, Morad Street (Morad Tower), Apart, Giza, Egypt, Cairo, Egypt
Chapter keywords
trabeculotome-guided deep sclerectomy, scleral flap, trabeculo-Descemet’s window, combined phacoemulsification and deep sclerectomy, third flap, scleral bed

Abstract

This chapter discusses trabeculotome-guided deep sclerectomy. Deep sclerectomy consists of dissecting a superficial scleral flap, followed by dissection of a deeper scleral flap that should expose an intact trabeculo-Descemet’s window, through which the aqueous will percolate. Surgical technique, combined phacoemulsification and deep sclerectomy, advantages of the technique and disadvantages are discussed. Each surgical technique for deep sclerectomy has its pros and cons. The classic posterior approach is the standard technique for deep sclerectomy, yet it is technically difficult with the possibility of missing the Schlemm’s canal plane; in that situation dissection of a successful third flap is even much more difficult. The trabeculotome-guided technique tries to minimize such an incidence; also it avoids severe surgical-induced thinning of the remaining scleral bed.

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