Molteno implants as a treatment for refractory glaucoma in black patients

Arch Ophthalmol. 1991 Oct;109(10):1417-20. doi: 10.1001/archopht.1991.01080100097051.

Abstract

Eighty-two black patients with refractory glaucoma were treated with a single-plate Molteno implant inserted in a single-stage procedure. A successful outcome (intraocular pressure less than or equal to 21 mm Hg with or without adjunctive medical therapy) was achieved in 72% of the patients with a mean follow-up of 30 months. Success was achieved in 23 (73%) of the 31 patients with open angle glaucoma, 20 (83%) of the 24 patients with either aphakic or pseudophakic glaucoma, 12 (67%) of the 18 patients with neovascular glaucoma, four (80%) of the five patients with uveitic glaucoma, and two (50%) of the four patients with congenital glaucoma. All but four patients required additional medical therapy. Visual acuities remained the same or improved in 21 (68%) of the 31 patients with open angle glaucoma, 11 (61%) of the 18 with neovascular glaucoma, 19 (79%) of the 24 patients with aphakic/pseudophakic glaucoma, three (75%) of the four patients with congenital glaucoma, and four (80%) of the five patients with uveitic glaucoma. Complications included hyphema (18%), "kissing" choroidal effusion (6%), blocked tube (8%), flat anterior chamber (12%), cataracts (5%), Tenon's cyst (encapsulated bleb) (17%), uveitis (7%), phthisis bulbi (5%), and erosion of the silicone tube (1%).

MeSH terms

  • Blacks
  • Follow-Up Studies
  • Glaucoma / drug therapy
  • Glaucoma / ethnology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure
  • Methods
  • Ophthalmic Solutions / therapeutic use
  • Postoperative Complications
  • Prostheses and Implants*
  • Silicone Elastomers
  • Treatment Outcome
  • Visual Acuity

Substances

  • Ophthalmic Solutions
  • Silicone Elastomers