Acb. Molteno et al., Otago glaucoma surgery outcome study - Long-term follow-up of cases of primary glaucoma with additional risk factors drained by Molteno implants, OPHTHALMOL, 108(12), 2001, pp. 2193-2200
Objective: This study was undertaken to provide data on the long-term resul
ts of cases of primary open-angle glaucoma with additional risk factors dra
ined by Molteno implants in the province of Otago, New Zealand.
Design: Prospective, noncomparative case series
Participants: One hundred thirty eyes of 103 patients drained by Molteno im
plants as the first surgery between 1984 and 1999.
Intervention: Insertion of Molteno implant (Ethicon Inc., Johnson & Johnson
, Somerv'ille, NJ) using the Vicryl-tie technique.
Main Outcome Measures: Intraocular pressure (IOP), visual acuity, visual fi
eld.
Results: Insertion of a Molteno implant controlled the IOP at 21 mmHg or le
ss with a probability of 1.0 (95% confidence interval [CI], 0.90, 1.0) at u
p to 7 or more years after surgery. The mean preoperative visual acuity of
20/160 improved to 20/50 after operation and then declined to 20/55 at 5 ye
ars and 20/80 after 10 years. The probability of retaining useful vision (v
isual acuity, > 20/400; visual field, >5 degrees radius) was 0.86 (95% CI,
0.77, 0.94) and 0.78 (95% CI, 0.67, 0.89) at 5 and 7 or more years, respect
ively, after surgery.
Conclusions: The insertion of Molteno implants using the Vicryl-tie techniq
ue in this series of 130 cases of primary open-angle glaucoma with addition
al risk factors controlled the IOP in all cases. (C) 2001 by the American,A
cademy of Ophthalmology.