Non‐penetrating deep sclerectomy (NPDS) is a non‐perforating filtration procedure used for the surgical treatment of medically uncontrolled open angle glaucoma. This procedure was developed in an attempt to avoid many of the postoperative complications of trabeculectomy.1 The major advantage of NPDS is that it precludes the sudden hypotony that occurs after trabeculectomy by creating progressive filtration of aqueous humour from the anterior chamber to the subconjunctival space, without perforating the eye.2 Preservation of the thin trabeculo‐Descemet's membrane, however, is technically challenging, particularly before the surgeon gains experience with this procedure.
Previous studies investigated the ability to use the femtosecond laser for photodisruption in the human sclera,3,4 and concluded that complete subsurface photodisruption can be accomplished in human sclera in vitro.
Toyran et al.5 in 2005 published their in‐vitro study that tested the feasibility of using femtosecond laser pulses to fistulise the human trabecular meshwork and concluded that, with appropriate exposure time and pulse energy, femtosecond photodisruption can be employed to create partial and full thickness ablation in the human trabecular meshwork without damaging the surrounding tissues.
In the study described here, we used femtosecond laser technology to perform subsurface photodisruption in the opaque sclera for NPDS surgery in a laboratory model.