Supra-tenon capsule placement of original Molteno vs Molteno 3 tube implants in black patients with refractory glaucoma: a single-surgeon experience.

OBJECTIVE To evaluate the efficacy of supra-Tenon capsule placement of original Molteno vs Molteno 3 tube implants (Molteno Ophthalmic, Dunedin, New Zealand) in black patients with refractory glaucoma. METHODS A retrospective study comparing the efficacy of supra-Tenon capsule placement of the original Molteno tube implant (130-mm(2) plate size) with the newer Molteno 3 tube implant (175-mm(2) plate size). Original Molteno tube implants were placed into 17 eyes and Molteno 3 tube implants into 27 eyes. RESULTS Success was defined as an intraocular pressure of 18 mm Hg or less with or without adjuvant medical therapy. The median follow-up periods were 24 months (range, 12-48 months) for the original Molteno-implanted group (hereafter referred to as the original Molteno group) and 18 months (range, 12-48 months) for the Molteno 3-implanted group (hereafter referred to as the Molteno 3 group). The median preoperative intraocular pressures were 30 mm Hg for the original Molteno group and 24 mm Hg for the Molteno 3 group. The median postoperative intraocular pressures were 13 mm Hg for the original Molteno group and 14 mm Hg for the Molteno 3 group. Using Kaplan-Meier analysis, survival percentages were 71% for the original Molteno group and 88% for the Molteno 3 group. Log-rank test for comparison of survival indicated no significant difference between the 2 groups (P > .25). CONCLUSIONS Supra-Tenon capsule placement of single-plate Molteno tube implants of different sizes can adequately control intraocular pressure in a group of patients with refractory glaucoma. Tenon capsule elimination seems to negate the effect of plate size.