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Molteno implants in children.

R Nesher1, M B Sherwood, M A Kass

  • 1Department of Ophthalmology. Hadassah Medical Center. Jerusalem. Israel; *Department of Ophthalmology, University of Florida. Gainesville. Florida; and †Department of Ophthalmology and Visual Sciences. Washington University School of Medicine. St. Louis. Missouri, U.S.A.

Journal of Glaucoma
|January 1, 1992
PubMed
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Molteno implants effectively reduced intraocular pressure in children with complex glaucoma. This surgical approach offers a viable option for pediatric glaucoma cases resistant to conventional treatments.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery

Background:

  • Glaucoma in children presents unique challenges due to complex etiologies and potential for vision loss.
  • Pediatric glaucoma often requires multiple surgical interventions and may be refractory to standard medical management.

Purpose of the Study:

  • To evaluate the efficacy and safety of Molteno implants in pediatric glaucoma patients.
  • To assess the impact of Molteno implantation on intraocular pressure (IOP) control and need for medication.

Main Methods:

  • Retrospective case series of 27 eyes in 20 children with glaucoma treated with Molteno implants.
  • Patients had diverse ocular comorbidities and a history of multiple prior glaucoma surgeries.
  • Follow-up ranged from 6 to 36 months, with pre- and postoperative IOP measurements recorded.

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Main Results:

  • Mean preoperative IOP of 34 mmHg decreased significantly to 19 mmHg at 1 month and 1 year post-surgery (p < 0.001).
  • 33.3% of eyes achieved IOP control without medication post-implantation.
  • 44.4% of eyes required additional surgical procedures.

Conclusions:

  • Molteno implants demonstrate significant IOP reduction in children with refractory glaucoma.
  • This surgical option is a valuable consideration for pediatric glaucoma cases unresponsive to standard therapies.
  • While effective, a notable proportion of patients may still require further surgical intervention.