Reverse flap dissection for glaucoma surgery.

Abstract

A modified reverse dissection of scleral flaps for glaucoma surgery is described. A conventional square or rectangular flap is designed with deep scleral incisions, the two radial incisions crossing the limbus. A horizontal tunnel is created parallel to the limbus within the peripheral cornea, joining the two radial incisions. This tunnel is then enlarged toward the sclera, gradually dissecting the whole scleral flap. This centrifugal cutting is opposite to the common centripetal cutting employed for scleral flaps. Advantages over conventional dissection include more precise dissection within the limbal area, smoother surfaces, and reduction of disturbing bleeding.