Heuer D K, Lloyd M A, Abrams D A, Baerveldt G, Minckler D S, Lee M B, Martone J F
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles.
Ophthalmology. 1992 Oct;99(10):1512-9. doi: 10.1016/s0161-6420(92)31772-5.
Previous studies have suggested that primary double-plate Molteno implantation may be beneficial. Therefore, the authors performed a randomized clinical trial to evaluate the relative effectiveness and safety of single- versus double-plate Molteno implantation.
From March 1988 to February 1990, 132 patients who underwent Molteno implantation for medically uncontrollable non-neovascular glaucomas in aphakia or pseudophakia were randomly assigned to receive either single- or double-plate implants.
The 1- and 2-year life-table success rates (success [survival] defined as 6 mmHg < or = final intraocular pressure [IOP] < or = 21 mmHg without additional glaucoma surgery or devastating complication) were 55% and 46% with single-plate implantation and 86% and 71% with double-plate implantation, respectively. The final postoperative visual acuities were within one line of the preoperative visual acuities or had improved in 73% and 80% of patients, respectively. Choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi were more common in the patients who had undergone double-plate Molteno implantation; however, transient elevations of IOP during the first few postoperative months were more common in the patients who had undergone single-plate Molteno implantation.
Double-plate Molteno implantation more frequently affords IOP control than single-plate Molteno implantation; however, double plates are associated with greater risks of choroidal hemorrhages and/or effusions, corneal decompensation, flat anterior chambers, and phthisis bulbi.
既往研究提示原发性双盘Molteno植入术可能有益。因此，作者进行了一项随机临床试验，以评估单盘与双盘Molteno植入术的相对有效性和安全性。
1988年3月至1990年2月，132例因无晶状体或人工晶状体眼的药物无法控制的非新生血管性青光眼而接受Molteno植入术的患者被随机分配接受单盘或双盘植入物。
单盘植入术的1年和2年生命表成功率（成功[存活]定义为最终眼压[IOP]≤21 mmHg且>6 mmHg，无需额外的青光眼手术或严重并发症）分别为55%和46%，双盘植入术分别为86%和71%。最终术后视力在术前视力的一行以内或有所改善的患者分别为73%和80%。脉络膜出血和/或渗出、角膜失代偿、无前房和眼球痨在接受双盘Molteno植入术的患者中更常见；然而，术后最初几个月眼压的短暂升高在接受单盘Molteno植入术的患者中更常见。
双盘Molteno植入术比单盘Molteno植入术更常能控制眼压；然而，双盘植入术与脉络膜出血和/或渗出以及角膜失代偿、无前房和眼球痨的风险更高相关。
