Primary single-plate Molteno tube implantation for management of glaucoma in children with Sturge-Weber syndrome.
OBJECTIVE
To evaluate the safety and efficacy of primary single-plate Molteno tube implantation in the management of childhood glaucoma associated with Sturge-Weber syndrome.


METHODS
Nine eyes of seven patients were included in this prospective case series. Success was defined as intraocular pressure (IOP) < or =22 mmHg with (relative success) or without (absolute success) glaucoma medications. Intra- and postoperative complications were also evaluated.


RESULTS
Mean age at the time of the surgery was 9.6 +/- 3.7 years (range: 5-17 years) and mean follow-up duration was 32 +/- 4.7 months (range: 20-36 months). Mean IOP was reduced from 34.2 +/- 8.3 mmHg preoperatively to 21.2 +/- 7.3 mmHg at the final follow-up (P = 0.012). The number of anti-glaucoma medications was reduced from 3.4 +/- 0.5 preoperatively to 2.2 +/- 1.3 at the final follow-up (P = 0.058). The cumulative probability of relative success was 97.2% [95% confidence interval (CI): 91.85-100%] at 12 months, 78.02% (95% CI: 60.36-95.67%) at 24 months and 43.34% (95% CI: 16.18-70.5%) at the final follow-up. During the first 6 months after surgery, two patients had controlled IOP without the use of medications (absolute success); however, 6 months and later no eye had achieved absolute success. There were no intraoperative complications. Postoperative complications included choroidal effusion necessitating drainage in three eyes (33.3%), cataract formation in one eye (11%) and retinal detachment in one eye (11%). At the final follow-up, visual acuity was unchanged from preoperative values in five eyes (55.5%); no eye demonstrated visual improvement.


CONCLUSIONS
Outcomes of this small case study reveal that primary single-plate Molteno tube implantation appears to be associated with a limited success rate and a relatively high complication rate in eyes of children with glaucoma resulting from Sturge-Weber syndrome.
Amini
Heydar
H
Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Razeghinejad
Mohammad Reza
MR
Esfandiarpour
Bahare
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D008297:Male; D018465:Molteno Implants; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation; D013341:Sturge-Weber Syndrome / Q000150:complications*; D014065:Tonometry, Ocular