Molteno3 Implantation as Primary Glaucoma Surgery

Välimäki, Juha; Ylilehto, Ari-Pekka A.

doi:10.1155/2014/167564

Cited by 10 publications

(4 citation statements)

References 15 publications

(27 reference statements)

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“…Primary BGI is effective at reducing IOP at 6 months, significantly decreases the medication burden, and is associated with relatively similar post-operative and visual acuity complications at 1 year compared to results seen in other studies, regardless of prior incisional ocular surgery [4, 25]. The current study adds substantial evidence that primary aqueous shunt implants in general can significantly lower IOP in patients with uncontrolled glaucoma and no prior incisional ocular surgery [27, 28]. While further randomized prospective studies are needed to establish definitively the comparative effectiveness of various procedures in the primary surgical management of patients with uncontrolled glaucoma, the current study supports an ever-expanding role for BGI.…”

Section: Discussionsupporting

confidence: 58%

Primary Baerveldt Shunt Implantation: Outcomes and Complications

et al. 2016

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IntroductionThis study is a retrospective case series to evaluate the outcomes and complications of Baerveldt glaucoma implant surgery (BGI) in patients without prior cataract or incisional glaucoma surgery.MethodsPatients who underwent 350-mm2 BGI through the Glaucoma Service of the University of Illinois at Chicago between 2010 and 2015 were included in this study. Outcome measures included age, sex, ethnicity, operated eye, preoperative diagnosis, preoperative, and sequential postoperative intraocular pressure (IOP), visual acuity, glaucoma medications, and postoperative complication and interventions. Statistical analyses were performed using the two-sided Student t test for continuous variables.ResultsThirty-seven patients were studied. IOP was consistently and statistically significantly lower at 3 months (17.4 ± 6.4, p = 3 × 10−7), 6 months (13.9 ± 5.1, p = 2 × 10−11), 1 year (12.2 ± 4.0, p = 9 × 10−10), and 2 years (14.6 ± 3.3, p = 0.0004) postoperatively compared to IOP at baseline (27.5 ± 8.1). Fewer glaucoma medications were used at 3 months (2.8 ± 1.3, p = 0.04), 6 months (2.6 ± 1.2, p = 0.02), 1 year (2.7 ± 1.7, p = 0.04), and 2 years (2.0 ± 1.2, p = 0.03) postoperatively compared to baseline (3.4 ± 1.1). A total of six cases (16%) had failure. A total of five patients (15%) had postoperative complications. Mean Snellen visual acuity was not statistically different at 6 months (0.5 ± 0.6, p = 0.88) or 1 year (0.4 ± 0.4, p = 0.57) postoperatively from baseline (0.5 ± 0.6).ConclusionsPrimary BGI is effective at reducing IOP and the medication burden in patients suffering glaucomatous optic neuropathy. Further randomized prospective studies are needed to compare various procedures in the primary surgical management of patients with uncontrolled glaucoma.FundingThis study was funded by an unrestricted grant from Research to Prevent Blindness.

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Section: Discussionsupporting

confidence: 58%

Primary Baerveldt Shunt Implantation: Outcomes and Complications

et al. 2016

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“…Valimaki and colleagues reported IOP reduction to 15.4 mm Hg with the Molteno3 implant (Molteno Ophthalmic Limited, Dunedin, New Zealand) in 38 patients with primary open angle glaucoma and pseudoexfoliative glaucoma. 26 Forty-seven percent of patients had no previous incisional ocular surgery, and 57% had only cataract extraction with intraocular lens implantation before Molteno implantation. Molteno and associates conducted a prospective comparative case series of trabeculectomy and single- and double-plate Molteno implantation as primary surgery.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Comparison of Primary Baerveldt Implantation versus Trabeculectomy with Mitomycin C

et al. 2016

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Purpose To compare the safety and efficacy of Baerveldt implantation and trabeculectomy with mitomycin C (MMC) in patients who have not had prior incisional glaucoma surgery. Design Retrospective comparative case series Patients A total of 125 patients with low risk glaucoma undergoing primary glaucoma surgery, including 55 patients who received a 350-mm2 Baerveldt glaucoma implant and 70 patients who had a trabeculectomy with mitomycin C Methods Eligible patients were identified using current procedural terminology codes, and their medical records were retrospectively reviewed. Main Outcome Measures The primary outcome measure was surgical success (IOP ≤ 21 mm Hg and reduced ≥ 20% from baseline, IOP > 5 mm Hg, no reoperation for glaucoma, no loss of light perception vision). Secondary outcome measures included visual acuity, intraocular pressure (IOP), number of glaucoma medications, and complications. Results The cumulative probability of success at 3 years with or without medical therapy was 87% in the Baerveldt group and 76% in the trabeculectomy group (p = 0.23). Postoperative complications occurred in 11 (20%) patients in the Baerveldt group and 20 (29%) patients in the trabeculectomy group (p = 0.27). Follow-up (mean ± SD) was 27 ± 19 months in the Baerveldt group and 34 ± 20 in the trabeculectomy group (p = 0.053). Conclusions Similar rates of surgical success and postoperative complications were observed with trabeculectomy with mitomycin C and Baerveldt implantation during 3 years of follow-up. Both are viable primary glaucoma procedures in patients without prior ocular surgery.

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“…This series analyzes a change in suture from Vicryl to Polysorb and a noticeable difference in tube opening time and post-operative complications. We hypothesize these [14,15]. This is a retrospective case review of eight patients.…”

Section: Discussionmentioning

confidence: 96%

Post-Operative Complications after Non-Valved Glaucoma Device Implantation Due to Rapid Polysorb™ Suture Absorption Time

M¹,

Connor²,

P³

et al. 2020

J Ophthalmic Surg

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Glaucoma is the most common optic neuropathy of adulthood. When conservative options including drops and/or lasers are not sufficient, surgery is needed. One surgical option to lower intraocular pressure (IOP) is the use of glaucoma drainage devices to allow secondary outflow through an artificial drainage system [1]. These implants shunt aqueous humor from the anterior chamber and can be valved on nonvalved [2]. Non-valved devices must be regulated to prevent free flow of aqueous fluid during the early postoperative period while a fibrous capsule is forming around the implant Case Series

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Molteno3 Implantation as Primary Glaucoma Surgery

Cited by 10 publications

References 15 publications

Primary Baerveldt Shunt Implantation: Outcomes and Complications

Primary Baerveldt Shunt Implantation: Outcomes and Complications

A Retrospective Comparison of Primary Baerveldt Implantation versus Trabeculectomy with Mitomycin C

Post-Operative Complications after Non-Valved Glaucoma Device Implantation Due to Rapid Polysorb™ Suture Absorption Time

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