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Non-penetrating deep sclerectomy for glaucoma surgery using the femtosecond laser: a laboratory model
  1. Irit Bahar,
  2. Igor Kaiserman,
  3. Graham E Trope,
  4. David Rootman
  1. Department of Ophthalmology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Dr Irit Bahar, Department of Ophthalmology, Toronto Western Hospital, 399 Bathurst Street, Ontario, Canada M5T 2S8; iritbahar{at}

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Non-penetrating deep sclerectomy (NPDS) is a non-perforating filtration procedure used for the surgical treatment of medically uncontrolled open angle glaucoma. This procedure was developed in an attempt to avoid many of the postoperative complications of trabeculectomy.1 The major advantage of NPDS is that it precludes the sudden hypotony that occurs after trabeculectomy by creating progressive filtration of aqueous humour from the anterior chamber to the subconjunctival space, without perforating the eye.2 Preservation of the thin trabeculo-Descemet’s membrane, however, is technically challenging, particularly before the surgeon gains experience with this procedure.

Previous studies investigated the ability to use the femtosecond laser for photodisruption in the human sclera,3 4 and concluded that complete subsurface photodisruption can be accomplished in human sclera in vitro.

Toyran et al.5 in 2005 published their in-vitro study that tested the feasibility of using femtosecond laser pulses to fistulise the human trabecular meshwork and concluded that, with appropriate exposure time and pulse energy, femtosecond photodisruption can be employed to create partial …

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  • Competing interests: None declared.