Molteno implants as a treatment for refractory glaucoma in black patients
J. Freedman and B. Rubin
Department of Ophthalmology, State University of New York, Brooklyn.
Eighty-two black patients with refractory glaucoma were treated with a
single-plate Molteno implant inserted in a single-stage procedure. A
successful outcome (intraocular pressure less than or equal to 21 mm Hg
with or without adjunctive medical therapy) was achieved in 72% of the
patients with a mean follow-up of 30 months. Success was achieved in 23
(73%) of the 31 patients with open angle glaucoma, 20 (83%) of the 24
patients with either aphakic or pseudophakic glaucoma, 12 (67%) of the 18
patients with neovascular glaucoma, four (80%) of the five patients with
uveitic glaucoma, and two (50%) of the four patients with congenital
glaucoma. All but four patients required additional medical therapy. Visual
acuities remained the same or improved in 21 (68%) of the 31 patients with
open angle glaucoma, 11 (61%) of the 18 with neovascular glaucoma, 19 (79%)
of the 24 patients with aphakic/pseudophakic glaucoma, three (75%) of the
four patients with congenital glaucoma, and four (80%) of the five patients
with uveitic glaucoma. Complications included hyphema (18%), "kissing"
choroidal effusion (6%), blocked tube (8%), flat anterior chamber (12%),
cataracts (5%), Tenon's cyst (encapsulated bleb) (17%), uveitis (7%),
phthisis bulbi (5%), and erosion of the silicone tube (1%).
