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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 mmHg 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<.001,P<.001,and P=.01,respectively).Visual acuity at final follow-up in non-enucleated 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 < 20/1200).The outcome depended mainly on progression of the underlying vascular disease.
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 mmHg 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 <.001, P < .001, and P = .01, respectively) .Visual acuity at final follow-up in non-enucleated 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 <20/1200). The outcome depended mainly on progression of the underlying vascular disease.