Main purpose of
this study was to analyse the efficacy and complications of Molteno implant
surgery in patients with severe uncontrolled neovascular glaucoma (NVG) in a
long term follow up.
Methods: 10
patients (10 eyes) with diabetes
and severe uncontrolled NVG underwent trabeculectomy (TE) with fornix based
flap and one plate Molteno implant under local anesthesia. Follow up period
ranged up to 6 years.
Results: IOP
control was achieved in the early postoperative period in all eyes. Regression
of neovascularisation was observed in this period with most common
complications: hyphaema in the early postoperative period in 3 eyes,
encapsulated filtering bleb, overfiltration hypotonia and inflammation. The
long-term follow up showed a tendency to encapsulating of the bleb, occlusion
of the end of the tube with blood, fibrin and fibrovascular tissue, IOP
elevation and keratopathy in some cases.
Conclusions: Long
term follow up reveals significant reduction in success rates of Molteno
implant surgery in severe NVG and could be only last method of choice in these
cases.