Postoperative systemic corticosteroid treatment and Molteno implant surgery: a randomized clinical trial.

Purpose: To determine whether it is possible to improve the surgical success of Molteno implantation by causing a general suppression of collagen synthesis with postoperative oral prednisolone.

Methods: Twenty-two patients requiring single stage, single-plate Molteno implantation were randomized into two study groups: the control group A and the systemic prednisolone treatment group B. Serum markers of collagen metabolism were monitored.

Results: A successful outcome at the end of the 6-month follow-up, defined as final IOP > or =6 mmHg and < or =22 mmHg with less or equal number of antiglaucoma medication as preoperatively and no additional surgery was achieved in 9 of 11 (82 %) patients of group A and in 5 of 10 (50 %) patients of group B (p= 0.18). There was a statistically significant decrease in serum markers of collagen synthesis in the group B but not in the group A.

Conclusion: The serum markers indicated a systemic effect of oral prednisolone on collagen synthesis in group B but it did not improve the surgical outcome as compared to the controls.