References
1. Dixon MW, Moulin TA, Margolis MS, et al. Comparative Outcomes of the Molteno3 and Baerveldt Glaucoma Implants. Ophthalmol Glaucoma. 2020;3(1):40 – 50.
2. Sun, PY et al. Diplopia in Medically and Surgically Treated Glaucoma Patients Ophthalmology. 2017 Feb; 124(2): 257 – 262.
3. Nour-Mahdavi K, Caprioli J. Evaluation of the hypertensive phase after insertion of the Ahmed glaucoma valve. Am J Ophthalmol 2003;136:1001 – 8.
4. Hong C‑H, Arosemena A, Zurakowski D, Ayyala RS. Glaucoma drainage devices: A systematic literature review and current controversies. Surv. Ophthalmol 2005; 50:48 – 60
5. Molteno AC, Fucik M, Dempster AG, Bevin TH. Otago Glaucoma Surgery Outcome Study: factors controlling capsule fibrosis around Molteno implants with histopathological correlation. Ophthalmology. 2003 Nov 30;110(11):2198 – 206)
6. Välimäki, J O et al. Molteno3 Implantation as Primary Glaucoma Surgery. J Ophthalmol. 2014; 2014: 167564.
7. Sheybani et al. Differences In Intraocular Pressure and Medication Usage Between The Baerveldt And Molteno Glaucoma Drainage Devices. 29th Annual Meeting of the (AGS), 2019
8. Molteno ACB, et al. Long-Term Results of Primary Trabeculectomies and Molteno Implants for Primary Open-Angle Glaucoma. 2011. Arch Ophthalmol; 129(11):1444 – 1450
Indications: The Molteno3® Glaucoma Drainage Device is indicated to reduce intraocular pressure in neovascular glaucoma and glaucoma where medical and conventional surgical treatments have not been successful, to control the progression of disease.
Contradictions: Patients with the following conditions may not be suitable candidates for the Molteno3® Glaucoma Drainage Device: 1. intraocular infection, 2. rheumatoid arthritis, scleritis and immune corneal melt syndromes, 3. Scleral Buckle.
Complications: Possible complications with the use of the Molteno3® Glaucoma Drainage Device include, but are not limited to: choroidal detachment, retinal detachment, expulsive haemorrhage, pupillary block, lenticulo-ciliary block, shallowing and flattening of the anterior chamber, intraocular infection, diplopia, loss of central vision, hypotony and corneal endothelial damage.
Adverse events: Possible adverse events with the use of the Molteno3® Glaucoma Drainage Device include, but are not limited to: corneal endothelial damage when the tube touches the corneal endothelium, breakdown of the tissues overlying the bleb, diplopia when the placement of the implant interferes with the action of the extraocular muscles, corneal decompensation, progression of lens opacities, cystoid macular oedema, retinal detachment and intraocular infection.
Precautions: Caution should be taken with supra-Tenon implantation; erosion of the conjunctiva is known to result from the raised edge of the oval pressure ridge (Molteno3® G‑Series).