Use of neodymium: YAG laser to open an occluded molteno tube.
A patient with refractory glaucoma secondary to trauma and repeat penetrating keratoplasty had Molteno implant surgery to control elevated intraocular pressure. Six weeks after surgery intraocular pressure rose abruptly, and a fibrinous membrane was seen covering and occluding the tip of the Molteno tube. The Q-switched neodymium (Nd):YAG laser was used successfully to open the membrane, with subsequent renewal of aqueous flow and control of intraocular pressure. Bevel-up cutting of the tube tip facilitates Nd:YAG laser opening of such an obstruction. We describe this use of the Nd:YAG laser and recommend bevel-up trimming of implant tubes in aqueous implant surgery.
Fiore
P M
PM
Glaucoma Consultation Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114.
Melamed
S
S
D000328:Adult; D000867:Anterior Chamber / Q000601:surgery; D016039:Corneal Transplantation; D005901:Glaucoma / Q000150:complications; D006801:Humans; D007429:Intraocular Pressure; D007834:Lasers; D008297:Male; D019736:Prostheses and Implants