Molteno implants as a treatment for refractory glaucoma in black patients.
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%).
Department of Ophthalmology, State University of New York, Brooklyn.
J
J
Freedman
B
B
Rubin
D044383:Black People; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008722:Methods; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012826:Silicone Elastomers; D016896:Treatment Outcome; D014792:Visual Acuity
D009883:Ophthalmic Solutions; D012826:Silicone Elastomers