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Long-term follow-up of traumatic glaucoma treated with Molteno implants
J R Fuller1, T H Bevin, A C Molteno
1Department of Ophthalmology, University of Otago Medical School, Dunedin, New Zealand.
Purpose:
To determine the long-term outcomes of patients with traumatic glaucoma treated with Molteno implants at Dunedin Hospital, New Zealand.
Design:
Prospective, noncomparative, interventional case series.
Participants:
Thirty-eight patients with traumatic glaucoma and with a mean follow-up of 10.9 years.
Intervention:
Insertion of Molteno implant.
Main Outcome Measures:
Intraocular pressure (IOP) and intraocular pressure-related surgical interventions after Molteno implant insertion.
Results:
Insertion of a Molteno implant controlled the IOP at 21 mmHg or less (with or without hypotensive medication) with a probability of 0.80 (95% confidence interval [CI], 0.66, 0.93) at 5 years and 0.72 (95% CI, 0.56, 0.88) at 10 years. At final follow-up, intraocular pressure was controlled solely with the implant in 26 cases and controlled with the addition of hypotensive medication in three cases, whereas nine eyes were failures. Eleven patients (29%) underwent intervention for implant repositioning or tube orifice blockage. Thirty-four double- and six single-plate Molteno implants were inserted. Two patients had implants replaced. Seventy-nine percent became aphakic or pseudophakic from their trauma before or at the time of Molteno implant insertion. There were no exclusions resulting from extensive ocular damage.
Conclusions:
Insertion of Molteno implants in traumatic glaucoma produced intraocular pressure control at long-term follow-up in 76% of cases.