Trabeculectomy and Molteno implantation for glaucomas associated with uveitis

Ophthalmology. 1993 Jun;100(6):903-8. doi: 10.1016/s0161-6420(93)31556-3.


Purpose: This study compares the outcomes of trabeculectomy and Molteno implantation in the treatment of glaucomas associated with uveitis.

Methods: Forty-five patients with uveitis, who had undergone filtering surgery for glaucomas associated with uveitis, were reviewed retrospectively. Successful outcome was defined as final intraocular pressure (IOP) of 6 to 21 mmHg, with a minimum follow-up of 6 months without visually devastating complications or loss of light perception.

Results: One- and two-year life-table success rates, respectively, were 81% and 73% with trabeculectomy (16 patients); 53% and 31% with combined trabeculectomy and first-stage (reserve) Molteno implantation (19 patients); and 79% and 79% with one-stage Molteno implantation (10 patients). In 11 patients who underwent second-stage Molteno implantation after trabeculectomy failure, 1- and 2-year life-table success rates were 79% and 79%, respectively. Complications included surgically treated choroidal effusions (1/45; 2%), choroidal hemorrhages (3/45; 7%), and chronic hypotony (3/45; 7%). Follow-up in all groups ranged from 5 to 70 months (mean +/- standard deviation, 28 +/- 17 months).

Conclusions: Trabeculectomy provides surprisingly good results in glaucomas associated with uveitis (modulation of wound healing with antimetabolites probably would afford an even higher success rate). However, when significant, immediate postoperative and/or moderate chronic postoperative inflammation is likely, aqueous drainage devices appear more likely to control IOP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Glaucoma / complications
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prostheses and Implants*
  • Retrospective Studies
  • Silicone Elastomers
  • Trabeculectomy*
  • Treatment Outcome
  • Uveitis / complications
  • Uveitis / surgery*


  • Silicone Elastomers