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[Molteno/von Denffer drainage implants in therapy-refractory glaucomas]
Klinische Monatsblatter Fur Augenheilkunde
|October 22, 2005
Summary
The Molteno implant effectively reduced intraocular pressure in severe glaucoma cases unresponsive to other treatments. This glaucoma drainage device helped conserve the eye in most patients, offering a last resort for vision preservation.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Surgical Interventions
Background:
- Glaucoma cases unresponsive to medical and surgical treatments present significant challenges.
- Eyes with existing blindness or uncontrolled intraocular pressure require advanced interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of the Molteno implant (von Denffer) in managing refractory glaucoma.
- To assess the long-term outcomes of Molteno implant surgery in a cohort of patients with severe glaucoma.
Main Methods:
- A retrospective study of 19 eyes treated with Molteno implants between 1995 and 2004.
- Patients had an average preoperative intraocular pressure of 44 mm Hg and a history of multiple prior surgeries.
- Diverse glaucoma types were included, such as primary, neovascular, PEX, traumatic, and postoperative glaucoma.
Main Results:
- Successful intraocular pressure control (<20 mm Hg) was achieved in 13 eyes, with 5 requiring adjunctive medications.
- Early complications were reversible; late complications included phthisis bulbi (3 eyes) and implant explantation (2 eyes).
- Visual acuity improved in 4 cases of traumatic and postoperative glaucoma, and stabilized in primary glaucoma cases.
Conclusions:
- Molteno implant (von Denffer) implantation is a viable option for eyes with persistent high intraocular pressure.
- Durable pressure reduction was achieved in approximately two-thirds of patients.
- Globe conservation was successful in three-fourths of the treated eyes, highlighting its role as a treatment of last resort.