Deep sclerectomy is a non-penetrating surgical procedure used to manage glaucoma. By carefully removing the outer layer of the sclera and unroofing Schlemm’s canal, this technique creates a natural drainage pathway for watery fluid (aqueous humour) in the eye. The procedure avoids entering the anterior chamber and lowers intraocular pressure with fewer complications compared to traditional surgery.
Procedure summary
Anaesthesia
Carried out under local or general anaesthesia for patient comfort.
Surgical Technique
A small incision is made in the sclera to form a partial-thickness flap. The surgeon then removes deep tissue over the drainage channel. This allows fluid to escape through a thin membrane (trabeculo-Descemet’s membrane) into an intrascleral space, creating a new outflow path.
Adjunctive Measures
Anti-scarring agents or spacers may be used to maintain the drainage space long-term. The area is then closed and allowed to heal naturally.
Clinical benefits
- Provides effective intraocular pressure reduction with a lower risk of complications like low eye pressure or inflammation
- Preserves the conjunctival surface, which is valuable if future eye surgery is needed
- Often results in faster recovery and less post-operative discomfort
- Reduces dependence on long-term glaucoma medications
