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Thompson AM, Molteno ACB, Bevin TH, Herbison P. Otago Glaucoma Surgery Outcome Study: Comparative Results for the 175-mm2 Molteno3 and Double-Plate Molteno Implants. JAMA Ophthalmol. 2013;131(2):155–159. doi:10.1001/2013.jamaophthalmol.165
Author Affiliations: Departments of Medicine (Drs Thompson and Molteno and Ms Bevin) and Preventive and Social Medicine (Dr Herbison), Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Objective To evaluate the efficacy of the 175-mm2 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-mm2 Molteno3 implant with those in a control group of 115 eyes receiving the 274-mm2 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-mm2 Molteno3 implant provided intermediate-term successful treatment of nonneovascular glaucoma comparable to that provided by the double-plate Molteno implant.
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