MOLTENO IMPLANT-SURGERY FOR ADVANCED GLAUCOMA

Purpose: The use of adjunctive antimitotics with conventional filtering surgery appears to have decreased the need for Molteno implants in glaucomas with a poor prognosis. We review the current status, results and complications of Molteno implants. Methods: Review of the literature and practical experience from two university departments of ophthalmology. Results: Improvements in the design and surgical techniques for Molteno implants have decreased the incidence of over filtration, but this and other complications continue to pose problems. Increased success rates may be possible if antimitotics are used with Molteno implants. Conclusion: Molteno implants continue to be an option when conventional filtration with or without antimitotics has failed; they continue to be regarded as a last resort for filtration. The use of antimitotics to increase the success rate of Molteno implants is not proven, but merits further investigation.