Molteno implant surgery in refractory glaucoma

Shlomo Melamed*, Philip M. Fiore

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

In recent years aqueous drainage implants have become a useful adjuvant in the treatment of refractory glaucomas. The Molteno implant is one of the most widely used devices for providing a permanent channel of aqueous flow from the anterior chamber to a collecting reservoir in the posterior subconjunctival space. Recently, modifications in design and surgical technique of the Molteno implant have enhanced its success rate, with a reduction in complications such as prolonged hypotony, anterior chamber flattening, and tube-corneal touch. These modifications include intracamerally injecting hyaluronic acid, using a needle track to provide an opening into the anterior chamber for the tube, performing the operation in two stages, using a double plate, temporarily ligating the tube, using a donor scleral patch, and giving adjunctive antifibrotic therapy. The rationale for application of the Molteno implant, the indications, techniques, results, and complications are described.

Original languageEnglish
Pages (from-to)441-448
Number of pages8
JournalSurvey of Ophthalmology
Volume34
Issue number6
DOIs
StatePublished - 1990
Externally publishedYes

Keywords

  • Molteno implant
  • filtration surgery
  • glaucoma
  • refractory glaucoma

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