Supra-Tenon's capsule placement of a single-plate Molteno implant.
OBJECTIVE
To describe clinical results of a new technique for inserting Molteno implants in a supra-Tenon's capsule location.


METHODS
Prospective interventional case study.


METHODS
19 patients, 18 of whom had suffered previous filter or glaucoma implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian.


METHODS
All patients underwent supra-Tenon's capsule placement of a single-plate Molteno implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery.


METHODS
Success was defined as intraocular pressure < or = 18 mm Hg with or without anti-glaucoma drugs.


RESULTS
Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12-48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p<0.001). Complications were minimal, characterised by small choroidal effusions in three patients; all resolved spontaneously.


CONCLUSIONS
Supra-Tenon's capsule placement of Molteno implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.
Freedman
J
J
Department of Ophthalmology, SUNY Health Science Center at Downstate, 161 Atlantic Avenue, Brooklyn, NY 11201, USA. jfreedman50@hotmail.com
Chamnongvongse
P
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D015355:Glaucoma, Neovascular / Q000601:surgery; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D018465:Molteno Implants; D011446:Prospective Studies; D012086:Reoperation; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014792:Visual Acuity