success rate and complications of single-plate molteno tube implantation in patients with glaucoma

purpose: to evaluate the success rate and complications of single-plate molteno tube implantation in patients with intractable glaucoma. methods: this study was conducted on records of patients who underwent molteno tube implantation from 1995 to 2000 and had at least 18 months of follow-up. results: thirty six eyes of 35 patients including 20 male and 15 female subjects with mean age of 29.7±25.3 yr (range 3-77 yr) were enrolled in the study. intraocular pressure (iop) was 34.48±10.39 mmhg with use of 2.3±0.8 drugs which decreased to 17.97±7.63 mmhg with 1.9±1.2 drugs after 32.8±16.14 months of follow-up. (p< 0.0001) complete success (iop £ 21 mmhg without medication), qualified success (iop £ 21 mmhg with medication), and total success rates (summation of complete and qualified success rates) were 19.5%, 55.6%, and 75%, respectively. at final follow-up, visual acuity was improved ≥ 1 line in 10 (27.8%), decreased ≥ 1 line in 8 (22.2%) and remained unchanged in 18 (50%) eyes. postoperative complications occurred in 20 eyes (55.6%) including encapsulated bleb in 10 (27.8%), tube-iris touch in 4 (11%), flat anterior chamber in 3 (8.4%), tube-corneal touch in 2 (5.6%), and retinal detachment, tube-lens touch, and tube blockage each in 1 (2.8%). intraocular pressure dropped to zero in one eye and vision was lost. conclusion: in eyes at high risk for trabeculectomy failure, implantation of the molteno tube can be considered as a procedure with high success for controlling intraocular pressure and preservation of vision. long term follow up is recommended to ensure adequate management of the frequent complications of this procedure.