Combined Molteno implantation and pars plana vitrectomy for neovascular glaucomas

Ten patients underwent combined Molteno implantation and pars plana vitrectomy as the primary nonlaser surgical treatment of neovascular glaucoma associated with diabetic retinopathy (9 patients) or central retinal vein occlusion (1 patient). Combined surgery was performed most frequently because media opacities precluded adequate preoperative retinal ablation. Follow-up ranged from 3 to 43 (mean +/- standard deviation, 18.0 +/- 13.2) months. Six patients achieved final intraocular pressures less than 22 mmHg. Visual acuities remained the same or improved in four patients. Four patients had uncomplicated courses. Among the other patients, complications included: recurrent vitreous hemorrhage and retinal detachment (3 patients each); hyphema (2 patients); and tube block, extensive fibrin formation, epiretinal membrane, and total retinal necrosis (1 patient each).