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

Abstract

To determine the long-term outcomes of patients with traumatic glaucoma treated with Molteno implants at Dunedin Hospital, New Zealand. Prospective, noncomparative, interventional case series. Thirty-eight patients with traumatic glaucoma and with a mean follow-up of 10.9 years. Insertion of Molteno implant. Intraocular pressure (IOP) and intraocular pressure-related surgical interventions after Molteno implant insertion. Insertion of a Molteno implant controlled the IOP at 21 mmHg or less (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% CI, 0.56, 0.88) at 10 years. At final follow-up, intraocular pressure was controlled solely with the implant in 26 cases and controlled with the addition of hypotensive medication in three cases, whereas nine eyes were failures. Eleven patients (29%) underwent intervention for implant repositioning or tube orifice blockage. Thirty-four double- and six single-plate Molteno implants were inserted. Two patients had implants replaced. Seventy-nine percent became aphakic or pseudophakic from their trauma before or at the time of Molteno implant insertion. There were no exclusions resulting from extensive ocular damage. Insertion of Molteno implants in traumatic glaucoma produced intraocular pressure control at long-term follow-up in 76% of cases.