The molteno implant in intractable glaucoma

Downes, R N; Flanagan, Declan; Jordan, K; Burton, Robert L.

doi:10.1038/eye.1988.50

Cited by 30 publications

(11 citation statements)

References 13 publications

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“…The success rate of our Molteno implant operations using IOP, medication and visual acuity as criteria is of the same order as reported previously (Goldberg 1987;Downes et al 1988;Minckler et al 1988;Douglas 1990;Smith & Shenvood 1990). Exact comparisons are dif€icult, however, since techniques and definitions vary.…”

Section: Discussionmentioning

confidence: 85%

Molteno implant surgery in uncontrolled glaucoma

Airaksinen

Aisala

Tuulonen

1990

Acta Ophthalmologica

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Molteno implant surgery was performed on 33 eyes of 29 patients with complicated and uncontrolled glaucoma. Average preoperative IOP was 34.0 +/- 8.8 mmHg. After a mean postoperative follow-up period of 18.3 months the IOP was 15.8 +/- 8.3 mmHg. Three patients had an IOP over 22 mmHg. Overall, success rate was 73% with IOP and medication as criteria. In 75% of eyes visual acuity improved or remained within two lines of the preoperative value. The highest success rate was 83% (10 of 12 eyes) in congenital and uveitic glaucoma when both IOP, medication and visual acuity were taken into account. At the end of the study 52% of eyes were controlled without medication. Complications included transient hyphema (21%), flat anterior chamber with hypotony, with or without choroidal detachment (12%), tube touch to lens or cornea (9%), and tube block with vitreous (3%).

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Section: Discussionmentioning

confidence: 85%

Molteno implant surgery in uncontrolled glaucoma

Airaksinen

Aisala

Tuulonen

1990

Acta Ophthalmologica

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“…11,18,19 After implantation, the flow rate and absorption of aqueous humor depend mainly on the area of the end-plate and the thickness of the fibrous encapsulation that forms around it. [19][20][21] Thinner and large surface areas are usually associated with lower postoperative IOP. 7,11 Therefore, before the development of the fibrous capsule (3-6 weeks after the surgery), the aqueous flows almost unrestrictedly through the shunt, favoring ocular hypotony unless additional measures are taken.…”

Section: Discussionmentioning

confidence: 99%

Laser Activated Flow Regulator for Glaucoma Drainage Devices

Olson

Vélez-Montoya

Bhandari

2014

Trans. Vis. Sci. Tech.

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“…The major disadvantage of the Molteno implant is excessive aqueous drainage in the immediate postoperative period, with a sub sequent flat anterior chamber and choroidal detachment [4,7,8,14], Several methods have been used to prevent this problem. In the "two-stage' procedure the footplate is sutured into position to allow a fibrous capsule to form around the plate, and then 4-6 weeks later the tube is inserted into the anterior chamber [ 19].…”

Section: Discussionmentioning

confidence: 99%

“…Good success rates have been reported for trabeculectomy in patients with primary glau coma [1], but in patients with secondary glau coma the success rates are much less encou raging [2][3][4][5][6][7][8][9][10][11][12][13][14], Failure of filtration surgery is usually related to excessive fibrosis with scar ring of the subconjunctival tissue. This tend ency is found more often in young patients and in those with secondary glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Use of the Single-Plate Molteno Implant in Refractory Glaucoma

et al. 1992

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During a 5-year period, 60 patients with uncontrolled glaucoma in one eye, who were considered to have a poor surgical prognosis with conventional drainage surgery, were treated with a single-plate Molteno implant. The surgery was performed in one operation and the tube tied with an absorbable suture in all cases. The overall follow-up was 20.3 ± 11 months (range 3–60). A successful outcome (defined as an intra-ocular pressure ≤21 mm Hg with or without treatment) was achieved in 56% of the 16 eyes with either aphakic or pseudophakic glaucoma, in 71% of the 14 eyes with uncontrolled glaucoma despite a previous filtering procedure, in 46% of the 13 eyes with traumatic glaucoma and in 64% of the 17 eyes with traumatic glaucoma and lens involvement. The visual acuity remained the same or better in 70% (42/60). Early complications of the surgery were transient and easily treated. Late complications included tube exposure in 3 (5%), tube retraction in 2 (3.3%), bleb encapsulation in 5 (8.3%) and corneal decompensation in 1 (1.65%). This study suggests that the single-plate Molteno implant is a useful drainage device with satisfactory results when used for the treatment of refractory secondary glaucoma.

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The molteno implant in intractable glaucoma

Abstract: Cambridge SummaryThe long term results in ninety-six cases of intractable glaucoma managed with the Molteno seton are presented. Over 50% of cases achieved satisfactory intraocular pressure control and visual stabilisation.

Cited by 30 publications

References 13 publications

Molteno implant surgery in uncontrolled glaucoma

Molteno implant surgery in uncontrolled glaucoma

Laser Activated Flow Regulator for Glaucoma Drainage Devices

Use of the Single-Plate Molteno Implant in Refractory Glaucoma

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