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Tan and Hitchings should be commended on attempting to tackle the issue of sclerectomy with collagen implant.1 Nevertheless we do feel that their fundamental points and principal arguments merit reconsideration.
The authors state categorically that “long term outcomes do not exit for the newer non-penetrating surgery technique” when, in fact, long term (43.2 months (SD 14.3)) results for deep sclerectomy with collagen implant have been published some time ago.2 The study provided a qualified success rate of 94.8% and the complete success rate of 61.9% after 60 months (survival analysis), with a mean IOP at end of follow up of 11.8 (SD 3) mm Hg. The study reported no surgically induced cataract in the whole series of 105 patients.
The authors, unfortunately, failed to cite a landmark study3 comparing deep sclerectomy without an implant with trabeculectomy …