Molteno Implant Surgery in Refractory Glaucoma

Lee, Sang Hyup

Abstract

The author evaluated the outcome of the Molteno implant drainage device. A retrospective chart review was performed on 26 eyes of 24 patients that had undergone Molteno implantation for uncontrolled glaucoma unresponsive to conventional treatment from February 1990 to December 1995 at the Pusan National Univeristy Hospital and had at least 6 months of follow-up data. Complete success was defined as a postoperative intraocular pressure of 22mmHg or lower without glaucoma medications, qualified success was same pressure as above with glaucoma medication and no additonal glaucoma surgery, or phthisis. The mean follow-up was 20.5 months(6-52 months). Indication for Molteno implantation were neovascular glaucoma(n=9), aphakia and pseudophakia(n=9), and other failed glaucoma filtering surgery(n=8). The total success was 65.4% (34.6% complete; 30.8% qualified). The aphakia/pseudophakia group had higher success rate than neovascular glaucoma and other failed operation groups. There was no significant statistical difference of the implant surgery adjunctive between with and without intraoperative Mitomycin_C. The Molteno implant surgery offers a reasonable outcome in eyes with intractable glaucomas. However, more effective device of method for modulation of wound healing for greater success is to be exepcted.