To report a case of Propionibacterium acnes endophthalmitis following uncompli cated cataract extraction with bacterial sequestration in a preexisting Molteno ’s drainage implant. Interventional case report. A 7 year...To report a case of Propionibacterium acnes endophthalmitis following uncompli cated cataract extraction with bacterial sequestration in a preexisting Molteno ’s drainage implant. Interventional case report. A 7 year old girl with conge nital glaucoma and a preexisting Molteno’s drainage implant developed anterior nongranulomatous uveitis 4 months following cataract surgery. P. acnes endophtha lmitis was diagnosed by polymerase chain reaction, Southern blot, and electron m icroscopy. Extraction of the Moltenos implant was required to control the pers istent intraocular inflammation and to convert the results of polymerase chain r eaction and Southern blot testing of aqueous sample for P. acnes from positive t o negative. P. acnes may be sequestered in glaucoma implants, potentially requir ing implant removal to treat cases of P. acnes endophthalmitis.展开更多
Purpose: The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a newtechniquewhere the silicone tube is inserted...Purpose: The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a newtechniquewhere the silicone tube is inserted into a scleral tunne l instead of being covered only by the con- junctiva. Methods: We reviewed Molteno implants carried out at theUniversity H ospital ofOulu, in 332 patientswho underwent traditionalMolteno implantation bet ween October 1986 and October 1998 and 92 patients who underwent surgery with th e new technique between November 1998 and April 2001. Results: With our former t echnique, conjunctival erosions occurred in 15 eyes of 15 patients (4.5%)-afte r a median follow-up of 3.5 months (range 1-72 months); no conjunctival compli cations were discovered in patients who underwent surgery using the new techniqu e during a median follow-up of 22 months (range 10-39 months). (p=0.038, twosa mple test of proportions). Conclusion: Inserting the Molteno tube into a scleral tunnel prevents tube extrusion through the conjunctiva in eyes with Molteno imp lants. The technique for making the scleral tunnel is described.展开更多
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...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.展开更多
Aims:To determine the long term outcome of Molteno implants inserted using a modified surgical technique that eliminates the need for a donor scleral graft.Methods:Retrospective case series involving a medical record ...Aims:To determine the long term outcome of Molteno implants inserted using a modified surgical technique that eliminates the need for a donor scleral graft.Methods:Retrospective case series involving a medical record analysis of 35 consecutive patients undergoing first Molteno implant surgery for refractory glaucoma.The main outcomes included life table analysis of intraocular pressure control following surgery and frequency of intraoperative and postoperative complications.Results:There were no complications related specifically to the modified method of tube placement.Medium term intraocular pressure control was similar to other series.Conclusions:This simpli-fiedmethod for the insertion of Molteno implants eliminates the need for a donor scleral graft while maintaining the implant’ s ability to control intraocular pressure.展开更多
Purpose:To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant(GDI)surgery.Methods:A total of 42 eyes of 34 consecutive patients with refractory glaucoma req...Purpose:To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant(GDI)surgery.Methods:A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed.Peritubular filtration was checked intraoperatively in all filtered eyes.Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage.All Molteno tubes were completely closed with an absorbable ligature.Results:Peritubular filtration was detected in 11 eyes of 11 patients.All 11 eyes maintained intraocular pressure(IOP)≥ 16 mmHg in the immediate postoperative phase.The mean IOP on the first postoperative day was 30.5± 10 mmHg.After an average follow-up of 6 months,the mean IOP in these 11 eyes was 19.1± 6 mmHg.No complications or Seidel-positive aqueous leak were observed during the follow-up period.Conclusions:Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery.展开更多
Purpose: In this retrospective study, we evaluated the surgical success results of Ahmed Glaucoma Valve (AGV), and single plate Molteno Tube Implant (MTI) in cases of neovascular glaucoma. Methods: 33 eyes of 33 neova...Purpose: In this retrospective study, we evaluated the surgical success results of Ahmed Glaucoma Valve (AGV), and single plate Molteno Tube Implant (MTI) in cases of neovascular glaucoma. Methods: 33 eyes of 33 neovascular glaucoma patients that underwent implantation of AGV and 25 eyes of 25 neovasular glaucoma patients that underwent implantation of MTI included to the study. Mean follow-up was 42.6±19.4 months in展开更多
An overview of the clinical indications requiring the use of implants will be presented. The course will discuss the physiology of blebs, maintenance of bleb function and clinical application. Prevention of hypotony b...An overview of the clinical indications requiring the use of implants will be presented. The course will discuss the physiology of blebs, maintenance of bleb function and clinical application. Prevention of hypotony by tubal ligation and other methods will be discussed. Different implants and their advantages and dis-展开更多
文摘To report a case of Propionibacterium acnes endophthalmitis following uncompli cated cataract extraction with bacterial sequestration in a preexisting Molteno ’s drainage implant. Interventional case report. A 7 year old girl with conge nital glaucoma and a preexisting Molteno’s drainage implant developed anterior nongranulomatous uveitis 4 months following cataract surgery. P. acnes endophtha lmitis was diagnosed by polymerase chain reaction, Southern blot, and electron m icroscopy. Extraction of the Moltenos implant was required to control the pers istent intraocular inflammation and to convert the results of polymerase chain r eaction and Southern blot testing of aqueous sample for P. acnes from positive t o negative. P. acnes may be sequestered in glaucoma implants, potentially requir ing implant removal to treat cases of P. acnes endophthalmitis.
文摘Purpose: The purpose of this study was to retrospectively evaluate whether it is possible to decrease the risk of Molteno tube erosion through the conjunctiva by using a newtechniquewhere the silicone tube is inserted into a scleral tunne l instead of being covered only by the con- junctiva. Methods: We reviewed Molteno implants carried out at theUniversity H ospital ofOulu, in 332 patientswho underwent traditionalMolteno implantation bet ween October 1986 and October 1998 and 92 patients who underwent surgery with th e new technique between November 1998 and April 2001. Results: With our former t echnique, conjunctival erosions occurred in 15 eyes of 15 patients (4.5%)-afte r a median follow-up of 3.5 months (range 1-72 months); no conjunctival compli cations were discovered in patients who underwent surgery using the new techniqu e during a median follow-up of 22 months (range 10-39 months). (p=0.038, twosa mple test of proportions). Conclusion: Inserting the Molteno tube into a scleral tunnel prevents tube extrusion through the conjunctiva in eyes with Molteno imp lants. The technique for making the scleral tunnel is described.
文摘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.
文摘Aims:To determine the long term outcome of Molteno implants inserted using a modified surgical technique that eliminates the need for a donor scleral graft.Methods:Retrospective case series involving a medical record analysis of 35 consecutive patients undergoing first Molteno implant surgery for refractory glaucoma.The main outcomes included life table analysis of intraocular pressure control following surgery and frequency of intraoperative and postoperative complications.Results:There were no complications related specifically to the modified method of tube placement.Medium term intraocular pressure control was similar to other series.Conclusions:This simpli-fiedmethod for the insertion of Molteno implants eliminates the need for a donor scleral graft while maintaining the implant’ s ability to control intraocular pressure.
文摘Purpose:To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant(GDI)surgery.Methods:A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed.Peritubular filtration was checked intraoperatively in all filtered eyes.Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage.All Molteno tubes were completely closed with an absorbable ligature.Results:Peritubular filtration was detected in 11 eyes of 11 patients.All 11 eyes maintained intraocular pressure(IOP)≥ 16 mmHg in the immediate postoperative phase.The mean IOP on the first postoperative day was 30.5± 10 mmHg.After an average follow-up of 6 months,the mean IOP in these 11 eyes was 19.1± 6 mmHg.No complications or Seidel-positive aqueous leak were observed during the follow-up period.Conclusions:Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery.
文摘Purpose: In this retrospective study, we evaluated the surgical success results of Ahmed Glaucoma Valve (AGV), and single plate Molteno Tube Implant (MTI) in cases of neovascular glaucoma. Methods: 33 eyes of 33 neovascular glaucoma patients that underwent implantation of AGV and 25 eyes of 25 neovasular glaucoma patients that underwent implantation of MTI included to the study. Mean follow-up was 42.6±19.4 months in
文摘An overview of the clinical indications requiring the use of implants will be presented. The course will discuss the physiology of blebs, maintenance of bleb function and clinical application. Prevention of hypotony by tubal ligation and other methods will be discussed. Different implants and their advantages and dis-
