Fig. 25. Deep sclerectomy with viscocanalostomy: management of episcleral bleeding. A. The management of episcleral bleeding is vastly different than with trabeculectomy in which the tendency is to eradicate all bleeders. The amount of cautery used to manage bleeding during trabeculectomy is far too much for nonpenetrating filtration surgery. Excessive cautery would obliterate the very episcleral collector system necessary for surgical success. B. A thrombin soaked sponge (5 mg/cc) applied for 1 minute to the proposed site is useful. Light cautery to the anterior ciliary artery may be necessary, one must try to avoid any cautery to the episcleral venous plexus.