Molteno® Implants Gluacome Drainage Device - Eyetube.net

MOLTENOT IMPLANT S Ghu,oma Drainage Deuices
Molteno@ Implants were developed for the treatment of severe and complex cases of glaucoma. The implants consist of a fine bore
silicone tube opening onto the upper surface of one or more episcleral plates. The function of the tube is to deliver aqueous from
within the eye onto the upper surface of the episcleral plate. The episcleral plate is firmly sutured to the sclera and covered by a
thick flap of Tenon's tissue and conjunctiva. The function of the plate is to initiate the formation of a large circular bleb which
develops a specialised fibrovascular bleb lining and becomes distended by aqueous. It is this fibrovascular bleb lining which is
responsible for regulating the escape of aqueous from the eye and which determines the final level of intraocular pressure (lOP) that
is achieved after insertion of the implant.
Molteno@ Implants are the treatment of choice for severe and complex cases of glaucoma. These are cases where standard drainage
procedures have failed or have a poor prognosis. They include failed trabeculectomy, buphthalmos and juvenile glaucoma, neovascular
glaucoma and glaucoma secondary to uveitis, traumatic glaucoma, cataract with glaucoma and high risk cases of primary glaucoma.
Single Plate Molteno@ Implant (Sl).
Particularly suitable for elderly patients with
reduced ciliary body function and for
combined cataract and glaucoma operations.
For acute glaucomas, this implant has been
superseded by the Pressure Ridge Single Plate
Moltenoo Implant, which provides better
control of postoperative hypotony.
Dimensions:
Ridge to fudge Diameter = I l.50mm
External Plate Diameter = 13.00mm
lvlaxlmtrm flate InlLKneS\ : l.O)mm
Tube Internal Diameter = 0.3+mm
Tube External Diameter = 0.64mm
Tianslimbal Tube l,ength = 25.00mm
Minimum Drainage Area l33mm2
Maximum Drainage Area 265mm2
Pressure Ridge Single Plate Molteno@ Implant (Dl).
The subsidiary ridge on this implant, when
covered by Tenon's capsule, acts as a pressure
sensitive biological valve which limits the
escape of aqueous from the eye and reduces
postoperative hypotony. This Molteno@
Implant is particularly suitable for
neovascular glaucomas, acute glaucomas in
patients with reduced ciliary body function,
elderly patients and combined cataract and
glaucoma procedures.
Microphthalmic Molteno@ Implant [Ml).
This is a mini version (plate diameter SmmJ
of the Single Plate Molteno@ Implant with a
reduced radius of curvature suitable for
microphthalmic eyes.
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Dimensions:
Ridge to Ridge Diameter = I L50mm
External Plate Diameter = l3.00mm
Malmum Piat. Thi.kness - Lo5mm
Tirbe Internal Diameter = 0.3z1mm
Ti.rbe External Diameter = 0.64mm
TianslimbalTube Length = 25.00mm
Minimum Drainage Area 133mm2
Maximum Drainage Area 265mm2
Dimensions:
Ridge to Ridge Diameter = 6.20mm
External Plate Diameter = 8.00mm
Maximum Plare lhitkne:: = Lbf mm
Tube lnternal Diameter = 0.3,1mm
Tube External Diameter = 0.6,1mm
tanslimbal Tube Length = 25.00mm
0501-GTl
MOLTENO'
OPHTHALMIC LIMITED
P O. BOX 6322 . DUNEDIN . NEw ZEALAND
TEL ++ 6,1 {013 479 2714. FAX ++ 64 [0J3 479 2444
EMAIL moltcno@ciear.net.nz . WEBSITE w!'N nolteno.coil

Double Plate Molteno@ Implant (RZ/LZ).
Twin plates provide twice the drainage area of a Single Plate Molteno@ Implant without interfering with the action of the
extra-ocular muscles. Particularly suitable for very severe glaucomas, patients with especially vigorous fibrous tissue response, younger
patients with good ciliary body function and glaucomas associated with uveitis and retinal detachment. This implant is available in
left eye [L2] and right eye (R2) configurations.
Dimensions:
Ridge to Ridge Diameter = I 1.50mm
Extemal Plate Diameter = i3.00mm
Maximum Plate Thickness = l.65rnm
Tube Internal Diameter = 0.34mm
'lube External Diameter = 0.64mm
'llanslimbal Ti.rbe t.ength = 25.00mm
Comrecting 'Iube l-ength = 10.00mm
Minimum Drainage Area 265mm2
Maximum Drainage Area 530mm2
Pressure Ridge Double Plate Molteno@ Implant IDR2/DLZ).
Combines the large drainage area of the Double Plate Molteno@ Implant with the subsidiary ridge for controlling postoperative
hypotony. Particularly suitable for very severe glaucomas, patients with good ciliary body function, younger patients and glaucoma
associated with retinal detachment. Available in left eye [DL2J and right eye [DR2] configurations.
Dimensions:
Ridge to Ridge Diameter = 1l.50mm
External Plate Diameter = l3.00mm
Maximum Plate Thickress = L65uun
Tube Internal Diameter = 0.34mm
Tube Erternal Diameter = 0.64mm
Tianslimbal Tube Length = 25.00mm
ConnectingTube Length = l0.00mm
N{inimum Drainage Area 265mm2
Maximum Drainage Area 530mm2
Features of the Molteno@ Implant range:
r Long-term biocompatibility is established.
o Double Plate Molteno@ Implants have twice the drainage
. Provides a robust and durable drainase svstem.
area of Single Plate Molteno@ Implants. The twin plate
. preplaced suture holes ensure correct positioning on the design gives a large drainage area while avoiding
globe.
o pressure Ridge Molteno@ Implants have a subsidiary ridge
which, *h.n corre.ed by Tenon's tissue, acts n, u pi".r.ri"
sensitive 'biological valve" limiting postoperative hypotony.
interference with the extraocular muscles.
' Choice of left or right eye configurations.
o Insertion is well described and straightforward.
'
The surgeon may select from a vafiety of ligature or stent
. procedures
Ine range or lmplanrs allows Ine surgeon ro choose the to improve the control of postoperative
, hvDotonv til
oralnage area accorolng ro rne severlry or rne graucoma.
hypotony and bleb fibrosrs'
A guide to the selection of a Molteno@ Implant:
Type of Molteno@ Implant
Glaucoma Drainage Device
Pressure Ridge Single Plate [Dl)
Pressure Ridge Double Plate Cniilonzl
_s:l_eF_PJ-1t: Il_ll
Double Plate [L2lR2)
Immediate Drainage
I
Ciliary Body
Poor Good
Delayed
Function
Poor
Drainage
Good
Microphthalmos
_l
MOLTENO'
OPHTHALMIC LIMITED
P O BOX 6322 . DUNEDIN . NEW ZEAI-AND
TEL ++ 64 [0)3 179 2714 . FA-\ ++ 64 (0)3 479 2444
Ei{AlL molt€no@cle3r.net.nz . UIEBSITE vww.molteno com