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Graft-free Molteno tube insertion: 10-year outcomes
  1. Lia Rossiter-Thornton1,
  2. Domit Azar1,2,
  3. James Leong3,
  4. Susan Lightman4,
  5. Hamish M A Towler4,5,
  6. Peter McCluskey2,3
  1. 1Concord Repatriation General Hospital, Sydney, Australia
  2. 2The University of Sydney, Sydney, Australia
  3. 3The Sydney Eye Hospital, Sydney, Australia
  4. 4Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London, UK
  5. 5Department of Ophthalmology, Whipps Cross University Hospital, London, UK
  1. Correspondence to Dr Peter McCluskey, Save Sight Institute, Sydney Eye Hospital, GPO Box 4337, Sydney NSW 2001, Australia; pmccluskey{at}

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This study is a 10-year consecutive case series of 34 patients with insertion of graft-free Molteno glaucoma drainage devices (GDDs) using our previously described technique.1 No grafts were used over this period on any patient having Molteno GDD insertion. Following quadrant conjunctival peritomy, a bent microvitreoretinal blade is guided through a small partial-thickness scleral incision 5–6 mm from the limbus, thence through the superficial scleral lamellae into the anterior chamber, creating a tunnel for the tube following removal of the blade, obviating the need for an overlying graft and thus eliminating the risk of variant Creutzfeldt–Jacob disease (vCJD) transmission. Although there are no reported cases of vCJD from donated eye tissue, its incubation period is unknown, and vCJD is thought to be a greater transmission threat than other …

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Sydney South West Area Health Service.

  • Provenance and peer review Not commissioned; externally peer reviewed.