MOLTENO IMPLANT-SURGERY FOR ADVANCED GLAUCOMA

Purpose: The use of adjunctive antimitotics with conventional filterin g surgery appears to have decreased the need for Molteno implants in g laucomas with a poor prognosis. We review the current status, results and complications of Molteno implants. Methods: Review of the literatu re and practical experience from two university departments of ophthal mology. Results: Improvements in the design and surgical techniques fo r Molteno implants have decreased the incidence of over filtration, bu t this and other complications continue to pose problems. Increased su ccess rates may be possible if antimitotics are used with Molteno impl ants. Conclusion: Molteno implants continue to be an option when conve ntional filtration with or without antimitotics has failed; they conti nue to be regarded as a last resort for filtration. The use of antimit otics to increase the success rate of Molteno implants is not proven, but merits further investigation.