Long-term follow-up of Molteno drains used in the treatment of glaucoma presenting in childhood

Purpose and methods This study reviews the long-term follow-up (mean 11.2 years, range 9 months to 16 years 9 months) of Molteno drains used in the treatment of glaucoma presenting in childhood, in 34 eyes of 25 patients. Results Intraocular pressure control was achieved in 85% of eyes, and vision (where measurable) was maintained in 57% of eyes. Seventy-one per cent of eyes required further surgical intervention. Thirty-two per cent of these cases were for drain-related problems, which may be avoidable with the use of current surgical techniques. The remaining interventions were for associated ocular defects, and for problems caused by multiple surgical procedures and periods of high intraocular pressure during early childhood. Conclusions Today the implants are used at an earlier stage in the disease process to try to obtain early and definitive IOP control and so help to optimise the long-term visual prognosis.