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Physiology and histology of deep sclerectomy

Results from animal studies should be applied with caution to the human clinical situation

The paper by Delarive et al in this month’s BJO (p 1340) studies the aqueous outflow characteristics and histology of deep sclerectomy (DS)—with (DSCI) and without collagen implant—in a rabbit model. This increasingly popular surgery has the advantage of fewer postoperative complications, as it is theoretically non-penetrating.1–3 The mechanism(s) by which DS and DSCI lower the IOP has been investigated non-invasively but not vigorously studied in an animal model with corresponding histology.

Ultrasound biomicroscopy …