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Comparison of double-plate Molteno and Ahmed glaucoma valve in patients with advanced uncontrolled glaucoma

Ramesh S Ayyala1, David Zurakowski, R Monshizadeh

  • 1Department of Ophthalmology, Tulane University Health Sciences Center, School of Medicine, New Orleans, Louisiana, USA.

Ophthalmic Surgery and Lasers
|April 11, 2002
PubMed
Abstract

Insights

Double-plate Molteno (DPM) and Ahmed glaucoma valve (AGV) showed similar long-term success rates for complicated glaucoma. DPM achieved lower intraocular pressure (IOP) over time compared to AGV.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Medical Devices

Background:

  • Complicated glaucoma requires effective surgical intervention.
  • Glaucoma drainage devices are crucial for managing intraocular pressure (IOP).
  • Comparing device efficacy is vital for clinical decision-making.

Purpose of the Study:

  • To compare the efficacy and safety of double-plate Molteno (DPM) versus Ahmed glaucoma valve (AGV) in treating complicated glaucoma.
  • To evaluate long-term outcomes, including IOP control and surgical success rates.

Main Methods:

  • A retrospective, matched case-control study included 30 patients per group (DPM vs. AGV).
  • Inclusion criteria: diagnosis, prior surgeries, age, and a minimum 6-month follow-up.
  • Success defined by IOP <22 mmHg, minimal visual acuity loss, and no further surgery.

Main Results:

  • Kaplan-Meier success rates at 24 months were 56% (DPM) and 50% (AGV).
  • Mean IOP was significantly lower with DPM at 12 months (13.36 mmHg) and 24 months (13.3 mmHg) compared to AGV (16.7 mmHg and 19 mmHg, respectively).
  • Hypertensive phase occurred more frequently with AGV (83.5%) than DPM (43.5%).

Conclusions:

  • Both DPM and AGV demonstrate comparable long-term success rates in managing complicated glaucoma.
  • Double-plate Molteno implantation is associated with superior long-term intraocular pressure reduction compared to the Ahmed glaucoma valve.

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