Outcome of Molteno implantation surgery in refractory glaucoma and the effect of total and partial tube ligation on the success rate.
OBJECTIVE
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.
Välimäki
J
J
Department of Ophthalmology, University of Oulu, Finland.
Tuulonen
A
A
Airaksinen
P J
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D008026:Ligation; D008297:Male; D008875:Middle Aged; D018465:Molteno Implants; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology