The success rate of DSCI may be comparable to that of trabeculectomy, with fewer complications.

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Hg (p=0.001). In all nine eyes, UBM at 1 month after surgery showed a subconjunctival filtration through the thin trabeculocorneal membrane and through the scleral flap around the collagen implant. In four cases, a hypoechoic area in the suprachoroidal space was observed and might represent ciliary body detachment or be due to suprachoroidal drainage of aqueous humour through the thin deep scleral wall. At 1 month after surgery the mean trabeculocorneal membrane thickness was 110.1 (16.8) rm, and the mean length and height of the collagen implant were 2.3 (0.1) mm and 1.1 (0.1) mm respectively. Conclusion-DSCI lowered lOP by allowing aqueous filtration through a thin trabeculocorneal membrane to the subconjunctival space and, eventually, to the suprachoroidal space. (BrJ Ophthalmol 1996;80:541-544) Deep sclerectomy with collagen implant (DSCI), a non-penetrating glaucoma surgery, was first described by Kozlov et al in 1989.' In this technique, a deep sclerectomy with thinning of the adjacent trabeculum and limbal cornea is performed. Although still under investigation, this procedure seems to be promising as it lowers the intraocular pressure (IOP) without perforation of the anterior chamber, thus reducing the occurrence of postoperative complications.High frequency ultrasound biomicroscopy (UBM) allows detailed anatomical assessment of the anterior eye segment. 'unroofed', and the corneal stroma was removed anteriorly down to the Descemet's membrane. At that stage of the procedure, aqueous humour was percolating through the thin trabecular corneal membrane. The collagen implant (Staar Surgica AG, Nidau, Switzerland) was then secured to the deep sclera by placing a 10/0 nylon suture at the midpoint of the triangular bed. The rectangular scleral flap was then closed and sutured with two 10/0 nylon sutures. The Tenon's capsule and the conjunctiva were closed with separate 8/0 silk sutures. Neither 5-fluorouracil nor mitomycin C had been used. Postoperatively the patients were treated with topical application of dexamethasone, neomycin, and polymyxin B drops (Maxitrol) four times daily for 1 month, followed by fluorometholone drops (Efemoline) three times daily for 5 months. COLLAGEN IMPLANTThe device is manufactured from microporous crosslinked collagen harvested from porcine sclera. In its dry state, the collagen device measures approximately 2.5 mm x 1.0 mm x 0.5 Hopital Ophtalmique