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The modified penetrating deep sclerectomy creates a small triangular intrascleral lake, which aims to reduce the risk of flap adhesion in conventional trabeculectomy and sudden hypotony associated with the dissection of a larger rectangular deep scleral flap. The primary effectiveness endpoint was the IOP by non\u2010contact tonometer with or without medication use at each follow\u2010up visit. The primary safety endpoint was the incidence of all complications during the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 19 patients (21 eyes) were randomized to modified deep sclerectomy and 21 patients (21 eyes) to conventional trabeculectomy. Age, sex ratio, pre\u2010operative intraocular pressure (IOP) and the number of IOP\u2010lowering medications used were comparable between the two groups. At the end of the follow\u2010up period (12\u2009months), IOPs were (15.52\u2009\u00b1\u20093.28) mmHg and (19.66\u2009\u00b1\u20094.01) mmHg in the modified deep sclerectomy and conventional trabeculectomy groups, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Deterioration of the visual field appeared in four eyes (19.0%) and seven eyes (33.3%) in the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.33). At 12\u2009months, the average areas of the aqueous outflow pathway were (0.67\u2009\u00b1\u20090.30) and (0.43\u2009\u00b1\u20090.26) mm\n                      <jats:sup>2<\/jats:sup>\n                      , demonstrating a significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Using 18 and 15\u2009mmHg as the IOP criteria for surgical success, the modified penetrating deep sclerectomy group showed a higher overall success rate than the conventional trabeculectomy group at 12\u2009months (18\u2009mmHg: 80.95% vs 52.38%, Log Rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033; 15\u2009mmHg: 52.38% vs 4.75%, Log Rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Complication rates were similar between the two groups (23.8% vs 33.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.55), and no sight\u2010threatening complications were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modified deep sclerectomy shows superior efficacy in IOP control and maintenance of the outflow pathway opening, with comparable rates of adverse events, resulting in a higher overall success rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.17465","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T23:42:11Z","timestamp":1740526931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Modified penetrating deep sclerectomy versus conventional trabeculectomy for the treatment of glaucoma: A 12\u2010month randomized prospective study"],"prefix":"10.1111","volume":"103","author":[{"given":"Zhike","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1781-5313","authenticated-orcid":false,"given":"Lixiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9476-3217","authenticated-orcid":false,"given":"Xin","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology West China Hospital, Sichuan University  Chengdu China"},{"name":"Department of Ophthalmology Shangjin Nanfu Hospital  Chengdu 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