[A proposed variation for glaucoma surgery]

When a trabeculectomy does not reduce the intraocular pressure, it is usually due to sealing of the scleral flap to the adjacent sclera, while the trabeculectomy itself remains open. A triangular excision in the scleral flap seems likely to keep the fistula in function. Deep sclerectomy does not lead to major hypotony, "the other complication" of trabeculectomy. However, the non perforating sclerectomy, under a sutured superficial scleral flap, could in the long term become inefficient. I propose a deep sclerectomy with controlled perforation under a notched superficial flap.