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Abstract #13146 Published in IGR 7-3

Otago Glaucoma Surgery Outcome Study: follow-up of young patients who underwent Molteno implant surgery

Ah-Chan JJ; Molteno AC; Bevin TH; Herbison P
Ophthalmology 2005; 112: 2137-2142

See also comment(s) by Donald Minckler


OBJECTIVE: To provide data on the results of patients with nonneovascular juvenile glaucoma who had Molteno implant surgery in the province of Otago, New Zealand. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fifty-five operations in 52 eyes of 45 patients with nonneovascular juvenile glaucoma who had Molteno implant surgery between the ages of 9 and 49 years from 1976 to 2003 at Dunedin Hospital and were observed for a mean of 12.2 years (range, 0.1-25). INTERVENTION: Insertion of a Molteno implant. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) and visual acuity (VA). RESULTS: Insertion of a Molteno implant controlled IOP at ≤ 21 mmHg with probabilities of 0.89 (95% confidence interval (CI), 0.81-0.97) at both 1 and 2 years and 0.85 (95% CI, 0.75-0.95), 0.78 (95% CI, 0.66-0.90), and 0.71 (95% CI, 0.58-0.85) at 5, 10, and 15 years, respectively. Mean VA was 20/100 preoperatively; improved to 20/60 at 1 year; and stabilized at 20/120 at 5, 10, and 15 years postoperatively. Twenty-nine eyes had their preoperative VA maintained or improved at final follow-up, and the VAs of 17 eyes deteriorated but were at least light perception at final follow-up. CONCLUSION: The use of Molteno implants in cases of nonneovascular juvenile glaucoma controlled IOP with a probability of 0.71 15 years postoperatively, whereas 53% maintained or improved their vision from their preoperative VA at final follow-up.

Dr. J.J. Ah-Chan, Eye Department, Dunedin Hospital, Dunedin, New Zealand


Classification:

12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)



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