Article Text

Download PDFPDF
Supra-Tenon’s capsule placement of a single-plate Molteno implant
  1. J Freedman,
  2. P Chamnongvongse
  1. Department of Ophthalmology, SUNY Health Science Center at Downstate, Brooklyn, NY, USA
  1. Professor J Freedman, Department of Ophthalmology, SUNY Health Science Center at Downstate, 161 Atlantic Avenue, Brooklyn, NY 11201, USA; jfreedman50{at}


Aim: To describe clinical results of a new technique for inserting Molteno implants in a supra-Tenon’s capsule location.

Design: Prospective interventional case study.

Participants: 19 patients, 18 of whom had suffered previous filter or glaucoma implant failure. Seventeen had open-angle glaucoma, and two had neovascular glaucoma. Seventeen patients were black and two were Asian.

Intervention: All patients underwent supra-Tenon’s capsule placement of a single-plate Molteno implant. Goldmann applanation tensions and Snellen visual acuities were determined before the operation and at the last follow-up visit. The numbers of preoperative and postoperative adjunctive drugs were compared before and after surgery.

Main outcome measures: Success was defined as intraocular pressure ⩽18 mm Hg with or without anti-glaucoma drugs.

Results: Mean age was 62 years. Mean pressure before and after surgery was 31 and 16 mm Hg, respectively. Mean follow-up was 22 months (range 12–48). Vision returned to within 2 lines of preoperative vision, except in one patient who lost light perception. Surgery was regarded as a failure in four patients, including both patients with neovascular glaucoma. The difference between the median number of drugs used before (three) and after (one) the operation was significant (p<0.001). Complications were minimal, characterised by small choroidal effusions in three patients; all resolved spontaneously.

Conclusion: Supra-Tenon’s capsule placement of Molteno implants in eyes with previously failed glaucoma surgery is an effective method for controlling intraocular pressure.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained.