Seven years of deep sclerectomy with implants – what do we have to improve?

IOP control without medication after deep sclerectomy and implants can be achieved in 40 to 60% of eyes at seven years, with a significant surgeon factor, and the need for a careful postoperative monitoring. Evaluating the ocular surface status, and treating it whenever possible, avoiding peroperative complications and modifying the predescemetic cornea removal approach, using combined pharmacological substances, and enhancing the subconjunctival filtration, are necessary to improve the rate of successful IOP control without additional medications.