Comparison of deep sclerectomy with collagen implant and trabeculectomy in open-angle glaucoma

J Cataract Refract Surg. 1999 Mar;25(3):323-31. doi: 10.1016/s0886-3350(99)80079-0.


Purpose: To assess the efficacy and postoperative complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure.

Setting: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland.

Methods: Forty-four eyes of 44 patients with medically uncontrolled open-angle glaucoma had DSCI and a matched control group of 44 patients, trabeculectomy. A superficial scleral flap was raised and a deep sclerectomy performed in the scleral bed. Schlemm's canal was opened, and the cornea was dissected to Descemet's membrane. At that stage, aqueous filtered through the remaining trabeculo-Descemet's membrane. A collagen implant was sutured radially in the scleral bed; the scleral flap and conjunctiva were then closed. Examinations were performed before surgery and postoperatively at 1 and 7 days and 1, 2, 3, 6, 9, 12, 15, 18, and 24 months.

Results: The mean follow-up was 14.4 months +/- 6.3 (SD) (range 3 to 24 months). The mean preoperative intraoperative pressure (IOP) was 26.7 +/- 7.3 mm Hg. The mean postoperative IOP was 6.1 +/- 4.5 mm Hg at 1 day and 11.0 +/- 4.4 mm Hg at 1 week; it remained stable for the next 24 months. The success rate, defined as an IOP lower than 21.0 mm Hg without medication, was 69% in the DSCI group and 57% in the trabeculectomy group at 24 months postoperatively (P = .047). The number of postoperative complications was significantly lower in the DSCI group than in the trabeculectomy group.

Conclusions: The success rate of DSCI may be comparable to that of trabeculectomy, with fewer complications.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Collagen*
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Glaucoma Drainage Implants*
  • Glaucoma, Open-Angle / drug therapy
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Intraocular Pressure
  • Male
  • Postoperative Complications / prevention & control
  • Sclerostomy / methods*
  • Trabeculectomy / methods*
  • Treatment Outcome


  • Immunosuppressive Agents
  • Collagen
  • Fluorouracil