Internal sclerostomy with laser: a new approach to glaucoma surgery

The creation of a fistula that permits controlled flow of aqueous from the anterior chamber to the subconjunctival space has been and remains the main technical goal of glaucoma filtering surgery. Currently, most complications are secondary to the surgical manipulation of the conjunctiva (mainly leakage from bleb and conjunctival fibrosis) or flattening of the anterior chamber. To overcome this problem, new methods are evolving in which the fistula is created from within the eye, with no conjunctival dissection. The performing of the sclerostomy by means of externally delivered laser energy is a further step in the same direction.