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Abstract #17151 Published in IGR 9-1
Molteno-implants in therapy-refractory glaucomas
Sulzer G; Jahne MSpektrum der Augenheilkunde 2006; 20: 264-266
BACKGROUND: In glaucoma eyes in which the pressure regulation was not possible with drugs and surgery or which were blind already, we treated the patients with a Molteno implant by von Denffer. MATERIALS AND METHOD: We treated 21 eyes between 1995-2005 with a glaucoma drainage device the Molteno implant developed by von Denffer. The average age of the patients was 64 (range: 15 to 77) years. On average 3.1 operations were performed before the implant. The average eye pressure was 45 mmHg preoperatively. Following glaucomas were found in our patients: 7 primary glaucomas (3 congenital, 1 open and 3 narrow angle glaucomas) and 14 secondary (4 postoperative glaucomas, 4 neovascular glaucomas, 3 traumatic, 2 PEX glaucomas and after uveitis). RESULTS: The intraocular pressure had a successful outcome of under 20 mmHg in 15 eyes, 5 patients out of these were treated with 1 to 3 local drugs. Early complications (flat anterior chamber, hyphaema, hypotonia) were reversible and were combinated. Late complications were phthisis bulbi (3x), explantation of the implant (2x) and one evisceratio bulbi. We found an improvement of the visual acuity in 4 cases in traumatic and postoperative glaucoma. The stabilisation of visual acuity was possible in primary glaucoma. CONCLUSION: The implantation of a valveless Molteno implant by von Denffer is an ultima ratio in eyes with persistent high intraocular pressure. A durable reduction of the pressure was possible in 71% of the eyes. Also the conservation of the bulbus was achieved in 80% of the patients. LA: German
Dr. M. Jahne, Augenklinik HELIOS, Klinikum Aue, Gartenstrasse 6, 08280 Aue, Germany. mjaehne@aue.helios-kliniken.de
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)