Capsule excision after failed Molteno surgery.
OBJECTIVE
To determine the frequency of scar tissue formation requiring surgical intervention after single-plate Molteno implantation and the outcome of excision of the encapsulated bleb.


METHODS
A retrospective study was performed on 95 eyes of 79 consecutive patients who underwent a single-stage Molteno implantation for refractory glaucoma. Fourteen eyes of 12 patients developed an encapsulated bleb. A successful outcome after bleb excision was defined as final intraocular pressure (IOP) between 6 and 22 mm Hg with the same amount of medication as preoperatively or less.


RESULTS
At the end of the mean follow-up of 30 months (range 8 to 75), the mean IOP (19.7 +/- 3.8 mm Hg) after bleb excision was significantly lower than the preoperative IOP (35.2 +/- 10.1 mm Hg; P < .001). The overall conventional success rate was 75%.


CONCLUSIONS
Excision of the encapsulated Molteno bleb offers an alternative in severely damaged eyes that have undergone several surgical procedures.
Välimäki
J
J
Department of Ophthalmology, University of Oulu, Finland.
Tuulonen
A
A
Airaksinen
P J
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D018465:Molteno Implants / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D014945:Wound Healing