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Anthony C. B. Molteno - One of the best experts on this subject based on the ideXlab platform.
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Otago Glaucoma Surgery Outcome Study: Examining the Development of Strabismus Causing Diplopia in Patients Who Have Received Molteno Implant Surgery.
Journal of binocular vision and ocular motility, 2020Co-Authors: Thomas Borowsky, Anthony C. B. Molteno, Tui H Bevin, Peter Herbison, Andrew M. Thompson, Logan MitchellAbstract:Objective: To evaluate the development of postoperative strabismus causing diplopia in patients who received Molteno Implant surgery for the treatment of glaucoma.Methods: The Otago Glaucoma Surger...
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Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction
Case reports in ophthalmology, 2017Co-Authors: Anmar M. Abdul-rahman, Anthony C. B. MoltenoAbstract:Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno Implant tube obstruction in a patient with mixed mechanis
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Otago Glaucoma Surgery Outcome Study: Further Histology and Immunohistochemistry of Molteno Implant Blebs.
Investigative ophthalmology & visual science, 2015Co-Authors: Anthony C. B. Molteno, Tui H Bevin, Alex G. Dempster, Fenella DevereuxAbstract:PURPOSE To describe findings of light microscopic examination of Molteno Implant bleb capsules. METHODS Histological and immunohistochemical features of bleb capsules including distribution of apoptotic cells and cell fragments were examined in 11 eyes 0.2 to 30.4 years after Molteno Implants. RESULTS In the superficial layer of capsules, high proportions of cells showed cytological features of apoptosis, with a higher proportion of cells showing specific immunohistochemical features of apoptosis with a mean of 22% (range, 3%-40%) of cells staining positively for Fas ligand. This demonstrated that cells migrating into the superficial capsule were replaced over approximately 1 to 6 days. In the deeper layer a mean of 8% (range, 3%-38%) of apoptosing cells stained positively for Fas ligand. These lower proportions of positively staining cells and cell fragments in the deeper layers, and the presence of occasional positively staining cells on the inner surface of capsules, demonstrated continuous migration of cells into the deeper layers associated with breakdown of connective tissue matrix and the release of numerous membrane-bound vesicles. CONCLUSIONS These findings demonstrated unexpectedly rapid turnover of cells in the superficial layer of the bleb capsule, where most cells were efficiently phagocytosed by nearby monocytic cells, macrophages, and histiocytes; the remaining cells migrating into the deeper layers completed apoptosis and disintegrated with release of collagenolytic enzymes and Fas ligand positive presumed "death messengers" that were carried toward the superficial layers by the aqueous.
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Otago glaucoma surgery outcome study: comparative results for the 175-mm2 Molteno3 and double-plate Molteno Implants.
JAMA ophthalmology, 2013Co-Authors: Andrew M. Thompson, Anthony C. B. Molteno, Tui H Bevin, Peter HerbisonAbstract:Objective To evaluate the efficacy of the 175-mm 2 Molteno3 Implant in patients with nonneovascular glaucoma. Methods A hospital-based, retrospective historical control comparative case series comparing results in the first 87 eyes to receive the 175-mm 2 Molteno3 Implant with those in a control group of 115 eyes receiving the 274-mm 2 double-plate Molteno Implant. Results Success was defined as an intraocular pressure (IOP) of at least 6 mm Hg but not more than 21 mm Hg with or without hypotensive medication. The mean postoperative follow-up was 3.0 years (range, 13 days to 5.6 years) in the Molteno3 Implant group and 6.2 years (range, 1 day to 13.9 years) in the double-plate Molteno Implant group. The mean (SD) preoperative IOP was 25.6 (7.1) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 2.3 ocular hypotensive medications, and 25.7 (8.0) mm Hg in the double-plate Molteno Implant group in eyes treated with a mean of 2.2 medications. The mean (SD) postoperative IOP at 36 months was 13.9 (3.2) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 0.9 ocular hypotensive medications, and 14.5 (3.4) mm Hg in the double-plate group in eyes treated with a mean of 0.7 medications. The probability of IOP control at 3 years was 0.79 in both groups. There was significantly more postoperative hypotony in eyes without a polyglactin 910 tie in the Molteno3 Implant group (P = .04); however, significantly more eyes with flat anterior chambers in the double-plate group required anterior chamber reformation (P = .03). Conclusion The 175-mm 2 Molteno3 Implant provided intermediate-term successful treatment of nonneovascular glaucoma comparable to that provided by the double-plate Molteno Implant.
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Otago glaucoma surgery outcome study: electron microscopy of capsules around Molteno Implants.
Investigative ophthalmology & visual science, 2011Co-Authors: Alex G. Dempster, Anthony C. B. Molteno, Tui H Bevin, Andrew M. ThompsonAbstract:UNLABELLED PURPOSE. To report the ultrastructure of cells and extracellular matrix components in Molteno Implant capsules examined by scanning and transmission electron microscopy. METHODS Ultrastructural features including cytology, distribution of apoptotic cells, collagens, basement membranes, elastic fibrils, and glycoproteins were examined by scanning and transmission electron microscopy. Findings were correlated with the clinical features of 31 specimens of glaucomatous eyes treated with Molteno Implants 0.3 to 14.9 years previously. RESULTS Capsules showed two layers: an outer, moderately cellular vascular layer of normal-appearing cells and collagen and an inner, avascular, hypocellular layer of altered cells and collagen. Cells included fibroblasts, myofibroblasts, and tissue histiocytes that showed features indicating metabolic activity, with swelling, vacuolation, and apoptosis, and the formation of numerous membrane-bound vesicles. These features, together with alteration and disintegration of extracellular matrix, increased with time after surgery. CONCLUSION The results support those in previous light microscopic studies and indicate that the normal life cycle of capsules in both primary and secondary glaucoma include continual outer surface renewal balanced by inner surface degeneration associated with apoptosis and breakdown of tissue matrix components which become more marked over time.
Peter Herbison - One of the best experts on this subject based on the ideXlab platform.
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Otago Glaucoma Surgery Outcome Study: Examining the Development of Strabismus Causing Diplopia in Patients Who Have Received Molteno Implant Surgery.
Journal of binocular vision and ocular motility, 2020Co-Authors: Thomas Borowsky, Anthony C. B. Molteno, Tui H Bevin, Peter Herbison, Andrew M. Thompson, Logan MitchellAbstract:Objective: To evaluate the development of postoperative strabismus causing diplopia in patients who received Molteno Implant surgery for the treatment of glaucoma.Methods: The Otago Glaucoma Surger...
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Otago glaucoma surgery outcome study: comparative results for the 175-mm2 Molteno3 and double-plate Molteno Implants.
JAMA ophthalmology, 2013Co-Authors: Andrew M. Thompson, Anthony C. B. Molteno, Tui H Bevin, Peter HerbisonAbstract:Objective To evaluate the efficacy of the 175-mm 2 Molteno3 Implant in patients with nonneovascular glaucoma. Methods A hospital-based, retrospective historical control comparative case series comparing results in the first 87 eyes to receive the 175-mm 2 Molteno3 Implant with those in a control group of 115 eyes receiving the 274-mm 2 double-plate Molteno Implant. Results Success was defined as an intraocular pressure (IOP) of at least 6 mm Hg but not more than 21 mm Hg with or without hypotensive medication. The mean postoperative follow-up was 3.0 years (range, 13 days to 5.6 years) in the Molteno3 Implant group and 6.2 years (range, 1 day to 13.9 years) in the double-plate Molteno Implant group. The mean (SD) preoperative IOP was 25.6 (7.1) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 2.3 ocular hypotensive medications, and 25.7 (8.0) mm Hg in the double-plate Molteno Implant group in eyes treated with a mean of 2.2 medications. The mean (SD) postoperative IOP at 36 months was 13.9 (3.2) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 0.9 ocular hypotensive medications, and 14.5 (3.4) mm Hg in the double-plate group in eyes treated with a mean of 0.7 medications. The probability of IOP control at 3 years was 0.79 in both groups. There was significantly more postoperative hypotony in eyes without a polyglactin 910 tie in the Molteno3 Implant group (P = .04); however, significantly more eyes with flat anterior chambers in the double-plate group required anterior chamber reformation (P = .03). Conclusion The 175-mm 2 Molteno3 Implant provided intermediate-term successful treatment of nonneovascular glaucoma comparable to that provided by the double-plate Molteno Implant.
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Long-term Results of Primary Trabeculectomies and Molteno Implants for Primary Open-Angle Glaucoma
Archives of ophthalmology (Chicago Ill. : 1960), 2011Co-Authors: Anthony C. B. Molteno, Tui H Bevin, Peter Herbison, Mohd Aziz HusniAbstract: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.
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Long-term results of Molteno Implant insertion in cases of chronic angle closure glaucoma.
Clinical & experimental ophthalmology, 2007Co-Authors: Sunil P Deokule, Anthony C. B. Molteno, Tui H Bevin, Peter HerbisonAbstract:Background: This study was undertaken to provide data on the long-term results of cases of chronic angle closure glaucoma with additional risk factors treated by Molteno Implants between 1985 and 2004 at Dunedin Hospital, New Zealand. Methods: A prospective non-comparative case series followed 21 eyes (17 patients) for a mean of 5.7 years (range 1.3–16.3 years) in terms of intraocular pressure, visual acuity and subsequent procedures. Results: Insertion of a Molteno Implant has controlled the intraocular pressure at 21 mmHg or less in 100% of cases at 5 years after surgery, the probability of control being 0.95 (95% CI 0.91–0.99). The mean number of hypotensive medications reduced from 2.04 (SD 0.92) preoperatively to 1.40, 0.64 and 0.66 at 1, 2 and 5 years, respectively. The mean visual acuity improved from 6/18 preoperatively to 6/12 at 1 year and declined to 6/13.5 at 2 and 5 years. Conclusion: Insertion of Molteno Implants was a safe and effective procedure in the management of complex cases of chronic angle closure glaucoma.
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Long-term Results of Molteno Implant Insertion in Cases of Neovascular Glaucoma
Archives of ophthalmology (Chicago Ill. : 1960), 2006Co-Authors: Sean G. Every, Anthony C. B. Molteno, Tui H Bevin, Peter HerbisonAbstract:Objective To describe the long-term outcomes of cases of neovascular glaucoma drained by Molteno Implants. Methods A prospective study of 145 eyes (130 patients) followed up for a mean of 3.3 years (range, 0.02 year [5 days] to 18.1 years) in the province of Otago, New Zealand, from 1979 to 2002. Results Insertion of a Molteno Implant controlled the intraocular pressure at 21 mm Hg or less with a probability (95% confidence interval) of 0.72 (0.64-0.80), 0.60 (0.51-0.69), and 0.40 (0.29-0.50) at 1, 2, and 5 years, respectively. Failure to control intraocular pressure at 1, 2, and 5 years was significantly correlated with persistent iris neovascularization ( P P P = .01, respectively). Visual acuity at final follow-up in nonenucleated eyes was maintained or improved in 56 eyes (39%) and deteriorated to light perception or better in 25 (17%) or no light perception in 47 (32%). Seventeen eyes (12%) were enucleated. Conclusions The insertion of Molteno Implants for neovascular glaucoma maintained or improved vision in 39% of eyes, whereas 12% were eventually enucleated (all of which initially had visual acuity
Tui H Bevin - One of the best experts on this subject based on the ideXlab platform.
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Otago Glaucoma Surgery Outcome Study: Examining the Development of Strabismus Causing Diplopia in Patients Who Have Received Molteno Implant Surgery.
Journal of binocular vision and ocular motility, 2020Co-Authors: Thomas Borowsky, Anthony C. B. Molteno, Tui H Bevin, Peter Herbison, Andrew M. Thompson, Logan MitchellAbstract:Objective: To evaluate the development of postoperative strabismus causing diplopia in patients who received Molteno Implant surgery for the treatment of glaucoma.Methods: The Otago Glaucoma Surger...
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Otago Glaucoma Surgery Outcome Study: Further Histology and Immunohistochemistry of Molteno Implant Blebs.
Investigative ophthalmology & visual science, 2015Co-Authors: Anthony C. B. Molteno, Tui H Bevin, Alex G. Dempster, Fenella DevereuxAbstract:PURPOSE To describe findings of light microscopic examination of Molteno Implant bleb capsules. METHODS Histological and immunohistochemical features of bleb capsules including distribution of apoptotic cells and cell fragments were examined in 11 eyes 0.2 to 30.4 years after Molteno Implants. RESULTS In the superficial layer of capsules, high proportions of cells showed cytological features of apoptosis, with a higher proportion of cells showing specific immunohistochemical features of apoptosis with a mean of 22% (range, 3%-40%) of cells staining positively for Fas ligand. This demonstrated that cells migrating into the superficial capsule were replaced over approximately 1 to 6 days. In the deeper layer a mean of 8% (range, 3%-38%) of apoptosing cells stained positively for Fas ligand. These lower proportions of positively staining cells and cell fragments in the deeper layers, and the presence of occasional positively staining cells on the inner surface of capsules, demonstrated continuous migration of cells into the deeper layers associated with breakdown of connective tissue matrix and the release of numerous membrane-bound vesicles. CONCLUSIONS These findings demonstrated unexpectedly rapid turnover of cells in the superficial layer of the bleb capsule, where most cells were efficiently phagocytosed by nearby monocytic cells, macrophages, and histiocytes; the remaining cells migrating into the deeper layers completed apoptosis and disintegrated with release of collagenolytic enzymes and Fas ligand positive presumed "death messengers" that were carried toward the superficial layers by the aqueous.
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Otago glaucoma surgery outcome study: comparative results for the 175-mm2 Molteno3 and double-plate Molteno Implants.
JAMA ophthalmology, 2013Co-Authors: Andrew M. Thompson, Anthony C. B. Molteno, Tui H Bevin, Peter HerbisonAbstract:Objective To evaluate the efficacy of the 175-mm 2 Molteno3 Implant in patients with nonneovascular glaucoma. Methods A hospital-based, retrospective historical control comparative case series comparing results in the first 87 eyes to receive the 175-mm 2 Molteno3 Implant with those in a control group of 115 eyes receiving the 274-mm 2 double-plate Molteno Implant. Results Success was defined as an intraocular pressure (IOP) of at least 6 mm Hg but not more than 21 mm Hg with or without hypotensive medication. The mean postoperative follow-up was 3.0 years (range, 13 days to 5.6 years) in the Molteno3 Implant group and 6.2 years (range, 1 day to 13.9 years) in the double-plate Molteno Implant group. The mean (SD) preoperative IOP was 25.6 (7.1) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 2.3 ocular hypotensive medications, and 25.7 (8.0) mm Hg in the double-plate Molteno Implant group in eyes treated with a mean of 2.2 medications. The mean (SD) postoperative IOP at 36 months was 13.9 (3.2) mm Hg in the Molteno3 Implant group in eyes treated with a mean of 0.9 ocular hypotensive medications, and 14.5 (3.4) mm Hg in the double-plate group in eyes treated with a mean of 0.7 medications. The probability of IOP control at 3 years was 0.79 in both groups. There was significantly more postoperative hypotony in eyes without a polyglactin 910 tie in the Molteno3 Implant group (P = .04); however, significantly more eyes with flat anterior chambers in the double-plate group required anterior chamber reformation (P = .03). Conclusion The 175-mm 2 Molteno3 Implant provided intermediate-term successful treatment of nonneovascular glaucoma comparable to that provided by the double-plate Molteno Implant.
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Otago glaucoma surgery outcome study: electron microscopy of capsules around Molteno Implants.
Investigative ophthalmology & visual science, 2011Co-Authors: Alex G. Dempster, Anthony C. B. Molteno, Tui H Bevin, Andrew M. ThompsonAbstract:UNLABELLED PURPOSE. To report the ultrastructure of cells and extracellular matrix components in Molteno Implant capsules examined by scanning and transmission electron microscopy. METHODS Ultrastructural features including cytology, distribution of apoptotic cells, collagens, basement membranes, elastic fibrils, and glycoproteins were examined by scanning and transmission electron microscopy. Findings were correlated with the clinical features of 31 specimens of glaucomatous eyes treated with Molteno Implants 0.3 to 14.9 years previously. RESULTS Capsules showed two layers: an outer, moderately cellular vascular layer of normal-appearing cells and collagen and an inner, avascular, hypocellular layer of altered cells and collagen. Cells included fibroblasts, myofibroblasts, and tissue histiocytes that showed features indicating metabolic activity, with swelling, vacuolation, and apoptosis, and the formation of numerous membrane-bound vesicles. These features, together with alteration and disintegration of extracellular matrix, increased with time after surgery. CONCLUSION The results support those in previous light microscopic studies and indicate that the normal life cycle of capsules in both primary and secondary glaucoma include continual outer surface renewal balanced by inner surface degeneration associated with apoptosis and breakdown of tissue matrix components which become more marked over time.
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Long-term Results of Primary Trabeculectomies and Molteno Implants for Primary Open-Angle Glaucoma
Archives of ophthalmology (Chicago Ill. : 1960), 2011Co-Authors: Anthony C. B. Molteno, Tui H Bevin, Peter Herbison, Mohd Aziz HusniAbstract: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.
Jeffrey Freedman - One of the best experts on this subject based on the ideXlab platform.
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Molteno Developments in Traditional Outflow Implants
Surgical Innovations in Glaucoma, 2013Co-Authors: Jeffrey FreedmanAbstract:The chapter will review the development of the Molteno glaucoma Implant. Included in the review will be: The historical progression of changes in design, describing the reasons for the modifications, as outlined by Molteno Important aspects relating to Implant material, shape, and size The development of procedures designed to overcome hypotony and bleb fibrosis, as well as the management of different stages of bleb development Modifications introduced by other ophthalmologists to facilitate additional aspects of difficulties that had arisen with the Implant The newer long-tube Implants, as regards their development in relation to the Molteno Implant The bleb as described in detail by Molteno and methods devised to improve bleb function including the role of cytokines What has been learned in 45 years since the introduction of the original Molteno Implant and how the use of glaucoma Implants is viewed presently
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pro inflammatory cytokines in glaucomatous aqueous and encysted Molteno Implant blebs and their relationship to pressure
Investigative Ophthalmology & Visual Science, 2013Co-Authors: Jeffrey Freedman, P IserovichAbstract:PURPOSE To ascertain the presence of additional pro-inflammatory cytokines in glaucomatous aqueous, and their relationship with IOP. METHODS To quantify the levels of 23 pro-inflammatory cytokines, and correlate levels with IOP, aqueous humor samples were analyzed from 23 eyes with open angle glaucoma (OAG) undergoing glaucoma filtration procedures, and from 24 Molteno blebs during the hypertensive phase. Control aqueous was derived from 13 eyes without glaucoma undergoing cataract removal. RESULTS A significant difference (P<0.05) was noted between hypertensive bleb aqueous and controls in the amount TGF-β2, interleukins IL-6, IL-10, and chemokine (C-X-C motif) ligand 1 (CXCL1; GROα). The levels of these cytokines were higher in the glaucomatous aqueous, but not significantly so. A significant difference was noted in levels of chemokine (C-C motif) ligand 2 (CCL2; MCP-1, monocyte chemotactic protein-1) in the glaucoma eye and bleb aqueous compared with controls. Of the 23 cytokines tested for, 19 were found in the bleb group, 14 in the glaucoma group, and 16 in the control group. Compared with controls, all cytokines levels were higher in the glaucoma group and highest in the bleb group. CONCLUSIONS The study confirms the well documented presence of TGF-β2 in glaucomatous aqueous. The presence of significant levels of CCL2 in glaucomatous aqueous is a new finding. The finding of higher levels of all the cytokines in the aqueous from the encysted blebs, in which the IOP was the highest, suggests that their levels increase with an increase in IOP, as well as the possibility that encysted blebs form cytokines.
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supra tenon s capsule placement of a single plate Molteno Implant
British Journal of Ophthalmology, 2008Co-Authors: Jeffrey Freedman, Pirahatai ChamnongvongseAbstract:Aim: To describe clinical results of a new technique for inserting Molteno Implants in a supra-Tenon’s capsule location. Design: Prospective interventional case study. Participants: 19 patients, 18 of whom had suffered previous filter or glaucoma Implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian. Intervention: All patients underwent supra-Tenon’s capsule placement of a single-plate Molteno Implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery. Main outcome measures: Success was defined as intraocular pressure ⩽18 mm Hg with or without anti-glaucoma drugs. Results: Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12–48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p Conclusion: Supra-Tenon’s capsule placement of Molteno Implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.
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Supra-Tenon’s capsule placement of a single-plate Molteno Implant
The British journal of ophthalmology, 2007Co-Authors: Jeffrey Freedman, Pirahatai ChamnongvongseAbstract:Aim: To describe clinical results of a new technique for inserting Molteno Implants in a supra-Tenon’s capsule location. Design: Prospective interventional case study. Participants: 19 patients, 18 of whom had suffered previous filter or glaucoma Implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian. Intervention: All patients underwent supra-Tenon’s capsule placement of a single-plate Molteno Implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery. Main outcome measures: Success was defined as intraocular pressure ⩽18 mm Hg with or without anti-glaucoma drugs. Results: Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12–48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p Conclusion: Supra-Tenon’s capsule placement of Molteno Implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.
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Management of the Molteno silicone tube in corneal transplant surgery.
Ophthalmic surgery and lasers, 1998Co-Authors: Jeffrey FreedmanAbstract:A method to prevent tube-corneal touch in patients with Molteno Implants who require corneal transplants is presented. A double-armed 10-0 Prolene suture is passed from limbus to limbus so that within the anterior chamber the suture acts as a splint for the silicone tube of the Molteno Implant, keeping it away from the cornea. This suture has been used in six patients, all aphakic or pseudophakic, requiring corneal transplants for bullous keratopathy. In all six patients, the silicone tube was successfully splinted away from the endothelium of the corneal transplant.
Pirahatai Chamnongvongse - One of the best experts on this subject based on the ideXlab platform.
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supra tenon s capsule placement of a single plate Molteno Implant
British Journal of Ophthalmology, 2008Co-Authors: Jeffrey Freedman, Pirahatai ChamnongvongseAbstract:Aim: To describe clinical results of a new technique for inserting Molteno Implants in a supra-Tenon’s capsule location. Design: Prospective interventional case study. Participants: 19 patients, 18 of whom had suffered previous filter or glaucoma Implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian. Intervention: All patients underwent supra-Tenon’s capsule placement of a single-plate Molteno Implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery. Main outcome measures: Success was defined as intraocular pressure ⩽18 mm Hg with or without anti-glaucoma drugs. Results: Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12–48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p Conclusion: Supra-Tenon’s capsule placement of Molteno Implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.
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Supra-Tenon’s capsule placement of a single-plate Molteno Implant
The British journal of ophthalmology, 2007Co-Authors: Jeffrey Freedman, Pirahatai ChamnongvongseAbstract:Aim: To describe clinical results of a new technique for inserting Molteno Implants in a supra-Tenon’s capsule location. Design: Prospective interventional case study. Participants: 19 patients, 18 of whom had suffered previous filter or glaucoma Implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian. Intervention: All patients underwent supra-Tenon’s capsule placement of a single-plate Molteno Implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery. Main outcome measures: Success was defined as intraocular pressure ⩽18 mm Hg with or without anti-glaucoma drugs. Results: Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12–48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p Conclusion: Supra-Tenon’s capsule placement of Molteno Implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.