الفهرس 
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Abstract
POAG is a chronic, multifactorial, and progressive optic neuropathy that causes visual field loss with characteristic loss of retinal ganglion cells, eventually leading to complete blindness. It can be present for a long time before patients have symptoms which make glaucoma the second leading cause of blindness in the world. The management of glaucoma should be designed to preserve vision and to achieve the best quality of life for the patient, whose total well-being is an integral part of the treatment plan. The treatment and management of a patient with POAG poses a great challenge for the physician and it resembles a complex puzzle. Studies shows that lowering the IOP can stop progression of the disease which is the only risk factor can be controlled. This control can be achieved by medical, LASER or surgical treatment. Surgery for POAG is indicated when there is progression of the disease despite of maximal medical or LASER treatment. Surgery also can be done if there is no compliance from the patient or when the disease affecting the patient quality of life or life style. Since 1830 till now, there a lot of surgical procedures was performed and developed with continuous trend toward improving the success rate and lowering the complications of filtering surgery. Trabeculectomy is the most frequently performed glaucoma filtering procedure to lower IOP. Successful filtration depends upon the establishment of an aqueous outflow pathway from the anterior chamber to the subconjunctival space and the formation of a functioning conjunctival filtering bleb. Trabeculectomy technique is achieved by formation of a conjunctival flap, scleral flap, sclerostomy and peripheral iridectomy, then closure of the flaps with formation of functioning conjunctival flap. Trabeculectomy is fraught with many complications either intraoperative or postoperative. Intraoperative complications include; Retrobulbar hemorrhage, buttonholing of the conjunctiva, scleral flap tearing or shrinkage and iris or ciliary body bleeding. The most serious postoperative complications include; hyphema, shallow and flat anterior chamber with either hypotony or raised IOP. Toward the goal of a safer and more reproducible glaucoma filtering surgery, non-penetrating filtering surgeries are now performed in primary open angle glaucoma. Different techniques of non penetrating surgeries are discussed. One of those non-penetration surgeries is deep sclerectomy. The idea of deep sclerectomy is to remove the corneal stroma behind the anterior trabeculum and Descemet’s membrane. Deep sclerectomy technique is performed through creation of conjunctival flap, superficial scleral flap, deep sclerectomy, exposure of the trabeculo Descemet’s membrane, unroofing of the Schlemm’s canal then closure of the created flaps. Complications of deep sclerectomy include; intraoperative and postoperative complications. The most important intraoperative complications are perforation of the trabeculo-Descemet’s membrane. Postoperative complications include; inflammation, hypotony and associated complications, hyphema, wound and bleb leak, blebitis, increase in IOP and keratitis. Some late postoperative complication can occur which include; late rupture of trabeculo-Descemet’s membrane, peripheral anterior synaechia, cataract formation, bleb fibrosis and scleral ectasia. One of the most stimulating questions regarding non-penetrating surgery is how well it fares compared to trabeculectomy, which for many decades was viewed as the gold standard against which all novel glaucoma procedures are tested. Many studies have performed to compare deep sclerectomy with trabeculectomy. Most of these studies found superior safety profile of deep sclerectomy but when it comes to the efficacy of both procedures, there is no significant difference. This is due to, the basic difference between deep sclerectomy as non-penetrating surgery and penetration trabeculectomy and the long learning curve of deep sclerectomy.