The purpose of this paper is to show the efficacy and safety of controlling intraocular pressure by combining a non-penetrating deep sclerectomy procedure with trabeculotomy, and analyze its results and complications.

Intraocular pressure equal to or less than 16 mmHg with or without medication was considered as a success. Between August 2005 and September 2006, 29 eyes were operated for open-angle glaucoma without control of the intraocular pressure in spite of maximum medication. 14 patients underwent non-penetrating deep sclerectomy with trabeculotomy and the others received combined phacoemulsification and intraocular lens implant. Average age was 71 years, with a range between 57 and 87. Sex distribution was 11 men and 18 women. Average presurgical intraocular pressure was 23.07 mmHg, with standard deviation +- 6.42 and a range between 17 and 45 mmHg. Average follow-up was 10 months with a range between 2 and 14.5 months. Pre-surgical and post-surgical intraocular pressures at 1, 2, 3, 6 and 12 months were analyzed. The surgical technic was as follows: Fornixbased conjunctival flap. Dissection of a scleral flap 4 × 3mm and 300μ thick. Paracentesis and phacoemulsification performed according to the case. Deep flap dissection unroofing the Schlemm canal and exposing the Descemet membrane. Juxtacanalicular tissue removed with forceps, and trabeculotomy performed on both sides. Sclera and conjunctiva were sutured. No antimetabolites, viscoelastics or any devices were employed to improve the results.

On average, latest post-surgical intraocular pressure was 12.25 mmHg, standard deviation +/-2.03 with a range between 8 and 16 mmHg. The difference between pre- and post-surgical measures was 11.53 mmHg. Only one eye (3.45%) out of 29 did not have intraocular pressure controlled and had to undergo a trabeculectomy. Intraocular pressure was controlled in 27 eyes (93.1%) without medication and in 1 eye (3.45%) with only one drop of medication. 18 cases had hyphema between 1 to 8 days post-surgery, resolved without consequences.

Combination of non-penetrating deep sclerectomy with trabeculotomy showed better results than each one separately, resulting in an alternative procedure for surgical treatment of open-angle glaucoma.