Preliminary Report of a Randomized Clinical Trial of Single Plate Versus Double Plate Molteno Implantation for Glaucomas in Aphakia and Pseudophakia

Our initial experience with single plate Molteno implants in complicated glaucomas was relatively favorable, with a 63% success rate in the aphakic and Pseudophakic patients on whom we were able to obtain at lest a 6 month follow-up; however, only 12% were successful without antiglaucoma medications and an intraocular pressure (IOP) of less than 16 mm Hg was achieved in only 27% (Minckler et al. 1988). Suboptimal IOP control with single plate Molteno implantation, plus ultimate IOP control in three of the five patients who underwent installation of a second single plate Molteno implant when one plate had not been sufficient suggested that primary double plate Molteno implantation might be advantageous. Molteno has stated that double plate implants are generally preferred except in eyes with limited inflow, in which case the implantation of double plates may eventuate in hypotony (Molteno 1986).