In the article titled, "Comparison of the Baerveldt Glaucoma Implant With the Double-Plate Molteno Drainage Implant" in the April 1995 issue of the Archives, Smith et al1 concluded that the intraocular pressure (IOP) control and visual acuity outcome were similar, regardless of which implant was used. However, in addition to the Baerveldt implant's large surface area, which allows for a 1-quadrant conjunctival incision, making surgery both technically easier and less extensive than double-plate Molteno implantation, the authors failed to discuss the difference in costs between the 2 implants.
Given the current managed care environment in which we practice and the need to be more cost conscious, the Baerveldt implant's higher cost is a factor that must be considered. The Baerveldt is more than double the cost of a single-plate Molteno implant and significantly more than the double-plate Molteno implant. Current prices for the shunts are as follows: Baerveldt implant,
Fitzgerald-Shelton K, Higginbotham EJ. Comparison of the Baerveldt Implant With the Double-Plate Molteno Implant. Arch Ophthalmol. 1996;114(8):1030. doi:10.1001/archopht.1996.01100140238038