Surgical Management of Glaucoma With Molteno3 Implant

Abstract

To evaluate the outcome of 40 consecutive patients with Molteno3 implantation in uncontrolled glaucoma with at least a 6-month follow-up. Nonrandomized, interventional, and retrospective clinical study. Failure was defined as IOP >21 mm Hg or less than 20% reduction of intraocular pressure (IOP) from baseline on 2 consecutive follow-up visits, IOP ≤5 mm Hg on 2 consecutive follow-up visits, reoperation of glaucoma or loss of light perception vision. The mean preoperative IOP was 34.3±9.1 mm Hg, and the mean postoperative IOP at the last follow-up visit was 16.8±7.5 mm Hg with a pressure drop of 19.1±11.5 mm Hg (56%) (P=0.000; 95% CI 13.5-21.4). The Kaplan-Meier life-table analysis showed a 95% success rate after 6 months and a 71% success rate after 12 months of follow-up. Postoperative complications included cataract (6 eyes), choroidal detachment (3 eyes), flat anterior chamber (2 eyes), malignant glaucoma (2 eyes), encapsulated bleb (2 eyes), corneal decompensation (2 eyes), hyphaema (1 eye), uveitis (1 eye), retinal detachment (1 eye), suprachoroidal hemorrhage (1 eye), tube erosion (1 eye), and phthisis bulbi (1 eye). The Molteno3 dual-chamber implant is useful and well tolerated in controlling IOP, but it does not seem to reduce the risk of postoperative hypotony.