High-frequency deep sclerotomy another option for surgical treatment of glaucoma

The challenge in the glaucoma surgery arena is the continued search for the ultimate glaucoma surgery technique that provides long-term IOP reduction, leading to the elimination of topical glaucoma eye drops, preservation of the ocular surface, along with low to no intraoperative and postoperative complications. Although trabeculectomy, initially described in the 1960s, continues to be the standard for effective IOP lowering, it is not readily welcome by ophthalmic surgeons due to its associated potential postoperative complications such as hypotony and choroidal detachment. A search for alternative techniques has led surgeons through the path of non-penetrating deep sclerectomy with or without a collagen implant, viscocanalostomy, penetrating sclerectomy, perforating deep sclerectomy, tube shunts and, more recently, minimally invasive glaucoma surgery procedures.While the menu of glaucoma surgical procedures continues to expand, there is no single procedure to date that provides the ideal glaucoma surgery for our patients. The enemy of a successful filtration procedure is the fibroblastic proliferation that ultimately leads to the demise of the filtering channel and obliteration of the bleb. In the absence of this ideal surgical procedure, surgeons have to pick from the available surgical procedures to best match the needs of the individual glaucoma patient.