[Non-penetrating filtering surgery: concept, technique and results].
Recently, many discussions occurred concerning non-penetrating filtering surgery. Viscocanalostomy and deep sclerectomy with external trabeculectomy are the most practiced techniques. Their goal is to reduce intraocular pressure by enhancing the natural aqueous outflow, while reducing its resistance. Both techniques involve the removal of a deep scleral flap, the external wall of Schlemm's canal and corneal stroma behind the anterior trabecular meshwork and Descemet membrane, thus creating a scleral lake, where the aqueous humor remains until it is absorbed in many different ways. In viscocanalostomy, a high-molecular viscoelastic substance is injected into the ostia of Schlemm's canal in order to enlarge it and its collectors channels. In deep sclerectomy with external trabeculectomy, the inner wall of Schlemm's canal is removed with adjacent trabecular layers. Studies, both retrospective and prospective, demonstrated similar tensional results when compared to classical trabeculectomy, with fewer complications and better visual recovery after non-penetrating procedure. The aim of this study is to expose the non-penetrating surgery techniques, mechanism of action and results based on the analysis of published literature.
Guedes
Ricardo Augusto Paletta
RA
Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil. palettaguedes@yahoo.com
Guedes
Vanessa Maria Paletta
VM
D002986:Clinical Trials as Topic; D018463:Filtering Surgery / Q000379:methods*; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome