Objective: To describe the long-term outcomes of primary trabeculectomies and primary Molteno implants performed in cases of primary open-angle glaucoma at Dunedin Hospital.
Methods: Prospective comparative case series of 718 eyes (500 patients) and 260 eyes (195 patients) that had trabeculectomy and Molteno implants, respectively, at Dunedin Hospital as the first drainage operation for primary open-angle glaucoma between 1976 and 2007, and followed up for a mean of 7.7 (range, 0.0-28.0) and 5.0 (range, 0.0-27.4) years, respectively.
Results: The probability of intraocular pressure (IOP) control at 21 mm Hg or less following trabeculectomy at 1, 2, 5, 10, 15, and 20 years was 0.95 (95% confidence interval [CI], 0.94-0.97), 0.93 (95% CI, 0.91-0.96), 0.89 (95% CI, 0.86-0.92), 0.82 (95% CI, 0.78-0.86), 0.74 (95% CI, 0.68-0.80), and 0.68 (95% CI, 0.59-0.77), respectively. There were 96 (13%) failures (using the >21-mm Hg definition of failure) in the trabeculectomy group by the final follow-up. The probability of IOP control at 21 mm Hg or less following Molteno implant insertion at 1, 2, 5, 10, 15, and 20 years was 0.98 (95% CI, 0.97-1.0), 0.97 (95% CI, 0.96-1.0), 0.96 (95% CI, 0.92-0.99), 0.96 (95% CI, 0.92-0.99), 0.91 (95% CI, 0.81-1.00), and 0.91 (95% CI, 0.81-1.00), respectively. In the Molteno implant group, there were 8 (3%) failures (using the >21-mm Hg definition of failure) by the final follow-up.
Conclusion: Insertion of a Molteno implant provided superior IOP control to trabeculectomy when carried out as a first operation in cases of primary glaucoma.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/archophthalmol.2011.221 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Meta-analysis of Molteno glaucoma implants and Ahmed glaucoma valves: insights into efficacy and safety for complex glaucoma.
Front Ophthalmol (Lausanne)
December 2023
Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan.
Background: Glaucoma is a leading cause of irreversible blindness globally and for decades, Molteno and Ahmed glaucoma implants, operating on different mechanisms, have been used to treat complicated glaucoma with varying success.
Objective: To assess the safety and efficacy of the Molteno glaucoma implant (MGI) versus the Ahmed glaucoma valve (AGV) in patients with complicated glaucoma.
Methods: We comprehensively searched PubMed, Google Scholar, Cochrane Library and Science Direct) from inception till July 2023 and studies comparing patients with MGI and those with AGV in patients with complicated glaucoma.
The efficacy of adjunctive mitomycin C and/or anti-VEGF agents on glaucoma tube shunt drainage device surgeries: a systematic review.
Graefes Arch Clin Exp Ophthalmol
October 2024
Department of Surgery and Physiology, UnIC@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal.
Purpose: The effectiveness of mitomycin C (MMC) in trabeculectomy has long been established. The aim of this review is to evaluate the efficacy and safety of adjunctive agents in tube shunt drainage device surgery for glaucoma or ocular hypertension, since controversy still exists regarding their benefit.
Methods: We searched CENTRAL, PubMed, Embase, Web of Science, Scopus, and BASE for RCTs, which have used adjuvant antimetabolites-either MMC or 5-Fluorouracil (5-FU)-and/or anti-vascular endothelial growth factors (anti-VEGF) agents.
Development and material characteristics of glaucoma surgical implants.
Adv Ophthalmol Pract Res
September 2023
Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Background: Glaucoma is the leading cause of irreversible blindness worldwide. The reduction of intraocular pressure has proved to be the only factor which can be modified in the treatment, and surgical management is one of the important methods for the treatment of glaucoma patients.
Main Text: In order to increase aqueous humor outflow and further reduce intraocular pressure, various drainage implants have been designed and applied in clinical practice.
Aqueous Shunts with Extraocular Reservoir for Open-Angle Adult Glaucoma: A Report by the American Academy of Ophthalmology.
Ophthalmology
February 2024
University of Florida College of Medicine-Jacksonville, Department of Ophthalmology, Jacksonville, Florida.
Purpose: To evaluate the recently published literature on the efficacy and safety of the use of aqueous shunts with extraocular reservoir for the management of adult open-angle glaucomas (OAGs).
Methods: A search of peer-reviewed literature was last conducted in April 2023 of the PubMed database and included only articles published since the last aqueous shunt Ophthalmic Technology Assessment, which assessed articles published before 2008. The abstracts of these 419 articles were examined, and 58 studies were selected for full-text analysis.
[Comparison of glaucoma drainage implants].
Ophthalmologie
April 2023
Klinik für Augenheilkunde, Universität Bonn, Ernst-Abbe-Str. 2, 53117, Bonn, Deutschland.
Glaucoma drainage devices (tubes, GDI or GDD) are nowadays an important surgical option in the treatment of refractory glaucoma. They are frequently used in cases where previous glaucoma surgery has failed or in patients with a history of conjunctival scarring where other procedures are contraindicated or simply not possible. This article looks at the evolution of glaucoma drainage implants from the very beginning to the multiple designs, experiences and research studies that have made tubes an essential part of the armamentarium of modern glaucoma surgeons.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!