CAPSULE EXCISION AFTER FAILED MOLTENO SURGERY

BACKGROUND AND OBJECTIVES: To determine the frequency of scar tissue f ormation requiring surgical intervention after single-plate Molteno im plantation and the outcome of excision of the encapsulated bleb. PATIE NTS AND METHODS: A retrospective study was performed on 95 eyes of 73 consecutive patients who underwent a single-stage Molteno implantation for refractory glaucoma. Fourteen eyes of 12 patients developed an en capsulated bleb. A successful outcome after bleb excision was defined as final intraocular pressure (IOP) between 6 and 22 mm Hg with the sa me amount of medication as preoperatively or less. RESULTS: At the end of the mean follow-up of 30 months (range 8 to 75), the mean IOP (19. 7+/-3.5 mm Hg) after bleb excision was significantly lower than the pr eoperative IOP (35.2+/-10.1 mm Hg; P<.001). The overall conventional s uccess rate was 75%. CONCLUSION: Excision of the encapsulated Molteno bleb offers an alternative in severely damaged eyes that have undergon e several surgical procedures.