Single-plate Molteno implants in complicated glaucomas: results, survival rates, and complications

Sixty-two single-plate single-stage Molteno implantations for complicated glaucomas were performed between March 1991 and November 1992. The charts of all these patients were reviewed to determine the intraocular pressure (IOP) control success rate (< 21 mm Hg with or without medications), visual success rate (retention or improvement of visual acuity from preoperative level) and the rate of complications encountered. A Kaplan-Meier life-table (survival) analysis was also performed. IOP control was obtained in 74.2% of cases. Mean postoperative IOP was 16.97 +/- 8.07 mm Hg (Mean +/- SD). Visual success was obtained in 51.6% of the eyes. Eyes with aphakia/pseudophakic glaucomas showed the best response with 80% of them achieving IOP control and 60% achieving visual success. The survival plot for IOP control revealed 75.81% and 74.19% success rates at 48 and 72 weeks, respectively. Complications encountered were either due to the early postoperative hypotony or were tube-related. These results were gratifying considering the severity of the glaucoma in these cases and they reaffirm the usefulness of the Molteno implant in the management of difficult glaucomas.