Outcomes of Single-Plate Molteno Implants in Refractory Glaucoma

Autor: Heidar Amini, Yadollah Eslami, Mohammad-Reza Razeghinejad, Maryam Kheradpajooh
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: Journal of Ophthalmic & Vision Research, Vol 1, Iss 2, Pp 101-105 (2008)
Druh dokumentu: article
ISSN: 2008-2010
2008-322X
Popis: PURPOSE: To evaluate the success rate and complications of single-plate Molteno tube implantation in patients with intractable glaucoma. METHODS: We reviewed the records of patients who had undergone single-plate Molteno tube implantation from 1995 to 2000 with at least 18 months of follow up. RESULTS: Thirty-six eyes of 35 (20 male and 15 female) patients with mean age of 29.7±25.3 (range 3-77) years were enrolled in the study. Preoperative intraocular pressure (IOP) was 34.5±10.4 mmHg with a mean of 2.3±0.8 medications which decreased to 18.0±7.6 mmHg with 1.9±1.2 medications after 32.8±16.1 months of follow up (P < 0.0001). Complete success (IOP: 7-21 mmHg without medications), incomplete success (IOP: 7-21 mmHg with medication) and total success (sum of complete and incomplete success) rates were 19.5%, 55.6%, and 75%, respectively. At final follow up, visual acuity improved 1 line or more in 10 (27.8%), decreased 1 line or more in 8 (22.2%) and remained unchanged in 18 (50%) eyes. Postoperative complications occurred in 20 eyes (55.6%) including encapsulated bleb in 10 eyes (27.8%), tube-iris touch in 4 (11%), flat anterior chamber in 3 (8.4%), tube-cornea touch in 2 (5.6%), and retinal detachment, tube-lens touch, and tube blockage, each in 1 (2.8%). IOP dropped to zero in one eye resulting in visual loss. CONCLUSION: In eyes at high risk for trabeculectomy failure, implantation of the Molteno tube can be considered as a procedure with acceptable success for control of IOP and preservation of vision. Long term follow-up is recommended to ensure timely management of the frequent complications of this procedure.
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