Outcomes of Single-Plate Molteno Implants in Refractory Glaucoma

Purpose: To evaluate the success rate and complications of single-plate Molteno tubeimplantation in patients with intractable glaucoma.Methods: We reviewed the records of patients who had undergone single-plate Moltenotube 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 decreasedto 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), incompletesuccess (IOP: 7-21 mmHg with medication) and total success (sum of complete andincomplete success) rates were 19.5%, 55.6%, and 75%, respectively. At final follow up,visual acuity improved ≥1 line in 10 (27.8%), decreased ≥1 line in 8 (22.2%) andremained 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%), flatanterior 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 eyeresulting in visual loss.Conclusion: In eyes at high risk for trabeculectomy failure, implantation of the Moltenotube can be considered as a procedure with acceptable success for control of IOP andpreservation of vision. Long term follow-up is recommended to ensure timelymanagement of the frequent complications of this procedure.