[Pars plana vitrectomy and cerclage after successful glaucoma operation with Molteno implant]

A single or double plate Molteno Implant may control IOP in otherwise desperate cases. Fibrosis of the filtration bleb will lead to failure. We report about 4 patients (age 12 to 77 years--3 neovascular glaucoma, 1 with postinflammatory goniosynechia) who had good IOP after the implantation of a Molteno device. 10 to 26 weeks (mean 18.25) after glaucoma surgery we performed a pars plana vitrectomy because of different reasons: proliferative diabetic retinopathy, proliferative retinopathy due to central venous occlusion, ciliovitreal block mechanism, PVR D3. One aphakic eye was treated with silicone oil and an encircling band. 19 to 30 weeks after posterior segment surgery (mean 24.5) IOP remained controlled. We describe the technique of pars plana approach and putting an encircling band without destroying the preformed filtration bleb. Encircling techniques, pars plana vitrectomy and silicone oil in aphacic eyes seem to bee possible without loss of the filtration effect of the Molteno operation.