Success Rate and Complications of Single-plate Molteno Tube Implantation in Patients with Glaucoma

To evaluate the success rate and complications of single-plate Molteno tube implantation in patients with intractable glaucoma.

This study was conducted on records of patients who underwent Molteno tube implantation from 1995 to 2000 and had at least 18 months of follow-up.

Thirty six eyes of 35 patients including 20 male and 15 female subjects with mean age of 29.725.3 yr (range 3-77 yr) were enrolled in the study. Intraocular pressure (IOP) was 34.4810.39 mmHg with use of 2.30.8 drugs which decreased to 17.977.63 mmHg with 1.91.2 drugs after 32.816.14 months of follow-up. (P< 0.0001) Complete success (IOP 21 mmHg without medication), qualified success (IOP 21 mmHg with medication), and total success rates (summation of complete and qualified success rates) were 19.5%, 55.6%, and 75%, respectively. At final follow-up, visual acuity was improved ≥ 1 line in 10 (27.8%), decreased ≥ 1 line in 8 (22.2%) and remained unchanged in 18 (50%) eyes. Postoperative complications occurred in 20 eyes (55.6%) including encapsulated bleb in 10 (27.8%), tube-iris touch in 4 (11%), flat anterior chamber in 3 (8.4%), tube-corneal touch in 2 (5.6%), and retinal detachment, tube-lens touch, and tube blockage each in 1 (2.8%). Intraocular pressure dropped to zero in one eye and vision was lost.

In eyes at high risk for trabeculectomy failure, implantation of the Molteno tube can be considered as a procedure with high success for controlling intraocular pressure and preservation of vision. Long term follow up is recommended to ensure adequate management of the frequent complications of this procedure.