Treatment Overview
Deep Sclerectomy in Korea is a non-penetrating glaucoma surgery designed to lower intraocular pressure (IOP) by enhancing the eye’s natural outflow system without entering the anterior chamber. Unlike trabeculectomy, deep sclerectomy removes a portion of the outer sclera to unroof Schlemm’s canal and create a filtration reservoir, allowing fluid to drain in a controlled, gentle manner.
Korean glaucoma centers are leaders in this refined technique, using OCT-guided scleral mapping, AI-assisted flap design, high-precision microsurgical tools, and viscoelastic implants to ensure consistent outcomes with fewer complications than full-thickness filtration surgery.
Purpose & Benefits
Purpose
- Lower IOP by improving natural aqueous humor outflow.
- Provide a safer, non-penetrating alternative to trabeculectomy.
- Reduce reliance on long-term glaucoma medications.
- Prevent further optic nerve damage in chronic glaucoma.
Benefits
- Non-Penetrating & Safer: Lower risk of hypotony, infection, and complications.
- Gentle and Controlled Outflow: Allows smoother pressure reduction.
- Less Inflammation: Minimal tissue disruption speeds healing.
- Reduced Postoperative Care Needs: Fewer intensive visits compared to trabeculectomy.
- Can Be Combined With Implants: Collagen or hyaluronic implants enhance flow.
- Long-Lasting Pressure Control: Suitable for many open-angle glaucomas.
Ideal Candidates
Deep sclerectomy in Korea is ideal for:
- Patients with primary open-angle glaucoma (POAG).
- Individuals with pseudoexfoliative or pigmentary glaucoma.
- Patients with elevated IOP not controlled with medications or laser treatment.
- Those who want fewer postoperative complications than trabeculectomy.
- Patients unable to undergo bleb-based surgery due to higher risk of complications.
- Individuals seeking a longer-term surgical solution with fast recovery.
Possible Risks & Complications
Although safer than penetrating surgery, potential risks include:
- Microperforation: Small accidental entry into the anterior chamber (usually manageable).
- Moderate inflammation: Easily controlled with drops.
- Transient IOP fluctuations: Stabilize over weeks.
- Implant migration or fibrosis: Reduced by Korea’s advanced anti-scarring techniques.
- Bleb-related issues (less common): Typically mild and controllable.
Korea reduces risks through OCT imaging, AI-enhanced planning, and high-precision surgical instruments.
Types of Deep Sclerectomy in Korea
Standard Deep Sclerectomy
Non-penetrating unroofing of Schlemm’s canal with filtration space creation.
Enhanced Deep Sclerectomy With Implants
Implants such as collagen or hyaluronic devices maintain filtration space.
Viscocanalostomy-Assisted Sclerectomy
Combines deep sclerectomy with canal dilation for improved outflow.
Combined Cataract + Deep Sclerectomy
Performed with phacoemulsification for patients with coexisting cataracts.
Laser-Assisted Sclerectomy Preparation
Femtosecond or holmium lasers help outline flaps for maximum precision.
Surgical Techniques
AI-Guided Preoperative Analysis
Assesses scleral thickness and canal anatomy to plan optimal flap geometry.
Superficial Scleral Flap Creation
A thin outer flap is created to regulate outflow.
Deep Scleral Flap Excavation
Surgeon removes deep scleral tissue to expose Schlemm’s canal.
Trabeculo-Descemet’s Membrane Formation
A thin membrane remains, controlling aqueous drainage without opening the eye.
Implant Placement (If Used)
Collagen/hyaluronic implants keep the drainage space open.
OCT Confirmation
Ensures correct flap depth and filtration pocket formation.
Treatment Process in Korea
Step 1 – Diagnostic Evaluation
Includes IOP testing, OCT, gonioscopy, visual field testing, and canal imaging.
Step 2 – Surgical Planning
Determines flap dimensions, implant use, and adjunctive anti-scarring strategy.
Step 3 – Deep Sclerectomy
Scleral flaps are created, tissue is removed, and filtration space established.
Step 4 – Implant Placement (Optional)
Enhances filtration longevity.
Step 5 – Postoperative Care
Includes anti-inflammatory drops and routine IOP checks.
Treatment Duration: 25–40 minutes
Setting: Outpatient or same-day surgical unit
Recovery & After-Care
After-Care Guidelines
- Use anti-inflammatory and antibiotic drops for 3–6 weeks.
- Avoid strenuous activities, heavy lifting, and rubbing the eyes.
- Wear protective shields during sleep initially.
- Attend scheduled follow-up visits for IOP and flap evaluation.
- Continue medications only if advised.
Recovery Timeline
- Days 1–3: Mild soreness or blurriness; IOP begins stabilizing.
- Week 1: Noticeable reduction in IOP.
- Weeks 2–4: Flap area heals; filtration space matures.
- Months 1–3: Full stabilization and long-term drainage achieved.
Results & Longevity
Expected Results
- Significant and stable reduction in intraocular pressure.
- Reduced dependence on medications.
- Lower risk profile compared to trabeculectomy.
- Effective long-term glaucoma management.
Longevity
- Results often last 8–15+ years, especially with implants.
- Korea’s imaging-guided techniques enhance long-term patency.
- Can be combined with additional MIGS or laser procedures if needed.
Why Korea Is a Top Destination
- World leaders in non-penetrating glaucoma surgery with high success rates.
- Advanced imaging (OCT/UBM) ensures ultra-precise flap depth and canal exposure.
- AI-guided surgical planning improves safety and predictability.
- Low complication rates compared to penetrating surgeries.
- Comprehensive post-op care ensures long-term stability.
Unique Korean Innovations
- AI-calibrated flap depth and geometry.
- OCT-integrated intraoperative guidance.
- Hybrid canaloplasty + deep sclerectomy workflows.
- Customized implant selection for optimal filtration.
- Predictive IOP stabilization modeling.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Deep Sclerectomy | ₩2,200,000 – ₩3,500,000 | ~$1,650 – $2,600 | Non-penetrating scleral surgery + routine care |
| Sclerectomy With Implant | ₩3,800,000 – ₩5,200,000 | ~$2,900 – $4,000 | Implant placement + imaging + anti-scarring protocol |
| Combined Cataract + Sclerectomy | ₩5,500,000 – ₩7,800,000+ | ~$4,100 – $5,800+ | Phaco + sclerectomy + extended follow-up |
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul) – Specializes in deep sclerectomy and non-penetrating glaucoma surgery.
- Dream Eye Center (Seoul) – Leaders in OCT-guided and implant-enhanced sclerectomy.
- BGN Eye Clinic (Busan & Seoul) – Experienced in combined cataract + sclerectomy procedures.
- Glory Seoul Eye Clinic – Experts in image-guided flap precision.
- K-Cure Vision Center (Gangnam) – Innovators in AI-assisted non-penetrating glaucoma surgery.
