Long-term follow-up of traumatic glaucoma treated with Molteno implants

Purpose: To determine the long-term outcomes of patients with traumatic gla ucoma treated with Molteno implants at Dunedin Hospital, New Zealand. Design: Prospective, noncomparative, interventional case series. Participants: Thirty-eight patients with traumatic glaucoma and with a mean follow-up of 10.9 years. Intervention: Insertion of Molteno implant. Main Outcome Measures. Intraocular pressure (IOP) and intraocular pressure- related surgical interventions after Molteno implant insertion. Results: Insertion of a Molteno implant controlled the IOP at 21 mmHg or le ss (with or without hypotensive medication) with a probability of 0.80 (95% confidence interval [CI], 0.66, 0.93) at 5 years and 0.72 (95% Cl, 0.56, 0 .88) at 10 years. At final follow-up, intraocular pressure was controlled s olely with the implant in 26 cases and controlled with the addition of hypo tensive medication in three cases, whereas nine eyes were failures. Eleven patients (29%) underwent intervention for implant repositioning or tube ori fice blockage. Thirty-four double- and six single-plate Molteno implants we re inserted. Two patients had implants replaced. Seventy-nine percent becam e aphakic or pseudophakic from their trauma before or at the time of Molten o, implant insertion. There were no exclusions resulting from extensive ocu lar damage. Conclusions: Insertion of Molteno implants in traumatic glaucoma produced i ntraocular pressure control at long-term follow-up in 76% of cases. Ophthal mology 2001;108:1796-1800 (C) 2001 by the American Academy of Ophthalmology .