Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate

Acta Ophthalmol Scand. 1998 Apr;76(2):213-9. doi: 10.1034/j.1600-0420.1998.760218.x.

Abstract

Purpose: To analyze the results of 87 consecutive one-stage Molteno implantations in 87 patients and evaluate the factors influencing the surgical outcome, especially the effect of intraoperative partial and total occlusion of the tube.

Methods: Successful outcome was defined as final intraocular pressure (IOP) between 6 and 22 mmHg with less or equal amount of glaucoma medication than preoperatively without loss of light perception.

Results: After a mean (+/-SD) follow-up of 24+/-17 months, the mean IOP was 18.1+/-16.0 mmHg compared to the preoperative mean of 42.4+/-11.1 mmHg (p<.0001). One-, 2- and 4.5-year life-table success rates were 90%, 75% and 50%, respectively. There was no statistically significant difference in the success rate between the eyes with total and partial tube occlusion (p=0.703). Postoperative hyphema, suprachoroidal hemorrhage and the number of systemic medications were the only factors significantly associated with failure.

Conclusions: Molteno implantation is warranted in patients with refractory glaucoma who have undergone numerous previous surgical procedures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Glaucoma / drug therapy
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Infant
  • Intraocular Pressure / physiology
  • Ligation
  • Male
  • Middle Aged
  • Molteno Implants*
  • Postoperative Complications
  • Postoperative Period
  • Retrospective Studies
  • Risk Factors
  • Treatment Failure
  • Treatment Outcome
  • Visual Acuity / physiology