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Performing accurate CO2 laser-assisted sclerectomy surgery

Most glaucoma surgeries achieve intraocular pressure (IOP) reduction by penetrating the sclerotrabecular wall. Deep sclerectomy surgery aims to enhance aqueous drainage without penetrating the globe and also aims to avoid some of the severe complications associated with violating ocular integrity; however, this procedure is difficult to perform manually in a safe and effective way. CO2 laser has been suggested as a tool to facilitate deep, effective ablation over the ocular drainage system to reduce IOP without penetrating the eyeball in a procedure called CO2 laser-assisted sclerectomy surgery. In this study, the authors report the rationale of choosing this type of laser, the development of the laser delivery and control systems (IOPtiMate; IOPtima, Tel Aviv, Israel) and the experimental and clinical experience to date.