Primary Single-Plate Molteno Implant for Pediatric Glaucoma Associated with Sturge-Weber Syndrome

Purpose: To evaluate the efficacy and safety of primary single-plate Molteno tubeimplantation for management of glaucoma in children with Sturge-Weber syndrome.Methods: Primary single-plate Molteno tube implantation was performed in eyes ofpatients with Sturge-Weber syndrome aged 17 years. Success was defined as intraocularpressure (IOP) .22 mmHg with (relative success) or without (absolute success)antiglaucoma medications. Intra- and postoperative complications were also evaluated.Results: Overall, nine eyes of seven patients with mean age of 9.6±3.7 (range 5-17) yearswere operated and followed for 32±4.7 (range 20-36) months. Mean IOP decreased from34.2±8.3 mmHg preoperatively to 21.2±7.3 mmHg at final follow up (P=0.012). Meannumber of antiglaucoma medications decreased from 3.4±0.5 preoperatively to 2.2±1.3 at final follow up (P=0.058). The cumulative probability of relative success was 97.2%(95% confidence interval [CI], 91.8-100%) at 12 months, 78.0% (95%CI, 60.4-95.7%) at 24months and 43.3% (95%CI, 16.2-70.5%) at final follow up. Two eyes achieved absolutesuccess during the first six months, however, at six months and later no eye achievedabsolute success. No intraoperative complication occurred; postoperative complicationsincluded choroidal effusion necessitating drainage in three eyes (33.3%), and cataractformation and retinal detachment, each in one eye (11%). At final follow up, visualacuity remained unchanged in five eyes and deteriorated in four eyes.Conclusion: The outcomes of this small series revealed that primary single-plateMolteno tube implantation appears to be associated with limited success and arelatively high complication rate in pediatric glaucoma associated with Sturge-Webersyndrome.