Nonpenetrating trabeculectomy with placement of a collagen drainage device.

Since the advent of trabeculectomy with antimetabolite therapy, there have been few changes in the surgical management of glaucoma. This is the first report of a new technique, nonpenetrating trabeculectomy with placement of a collagen drainage device. The procedure facilitates aqueous drainage without entering the human eye. Meticulous surgical dissection of the trabecular meshwork is required with creation of an external filtration tract and subscleral positioning of a collagen device to facilitate aqueous drainage. With this procedure, the surgeon can avoid common complications of glaucoma surgery such as synechias, overfiltration, hypotony, intraocular infection, uveal prolapse, and failed surgical blebs. The procedure and device have been used extensively in Russia.