Biomedical subjects

G Baerveldt

Publications and source records attributed to G Baerveldt.

At least 37 records · Page 2Linked to original sources

PubMed1995

Circadian rhythm of intraocular pressure: a rat model.

The purpose of this study was to examine whether there is a circadian rhythm of intraocular pressure (IOP) in the Lewis rat. Therefore, 20 Lewis rats (40 eyes) were subjected to an alternating 12-hour-light and 12-hour-dark cycle. Using a Tono-Pen 1, IOP was measured every 2 h between 6 a.m. and 12 midnight and every 3 h between 12 midnight and 6 a.m. for 2 consecutive days. These measurements in the Lewis rat revealed a reproducible circadian rhythm with a peak at 8 p.m. and a trough at 6 a.m. In conclusion, when using the Lewis rat as an animal model in longitudinal studies that involve the IOP, the IOP should be measured at the same time each day to correct for diurnal variations. Additionally, Lewis rats may be a useful model to study the causes of circadian rhythms of IOP and for pharmacologic studies of new glaucoma medications.

Animals↗

PubMed1995

Measurement of rabbit intraocular pressure with the Tono-Pen.

A Tono-Pen-1 (TP-1) and a Tono-Pen-2 (TP-2) were calibrated against direct manometry in the eyes of living rabbits to determine the accuracy of the Tono-Pen. Eighteen normal eyes of 10 rabbits were cannulated and connected to a pressure transducer with a chart recorder. Intraocular pressure (IOP) was increased from 5 to 40 mm Hg in 5-mm-Hg increments and from 40 to 80 mm Hg in 10-mm-Hg increments. After each incremental increase, IOP was measured first with a TP-1 and then with a TP-2. Plotting the mean Tono-Pen readings for each eye against the transducer pressure produced the following two regression line formulas: y = -0.613+0.790x (r2 = 0.97) for TP-1, and y = -1.45+0.824x (r2 = 0.97) for TP-2. Neither regression line was statistically different; p = 0.2 for the two slopes, and p = 0.24 for the y-axis intersection. The TP-1 and TP-2 can be used to rapidly and accurately measure the IOP in normal rabbit eyes. Tono-Pen readings do, however, significantly underestimate pressures in the range of 5-80 mm Hg. A table with 95% confidence intervals for corrected IOP readings obtained with the TP-1 or -2 is provided.

Animals↗

PubMed1994

Animal model for uveitic glaucoma.

BACKGROUND: This study was carried out in order to improve the understanding of the pathogenesis of uveitic glaucoma. METHODS: Uveitis was induced in 48 Lewis rats by S-antigen injection. Intraocular pressure (IOP) was measured by Tono-Pen-2 daily for 24 days in 16 animals. Histopathology was performed sequentially in 14 rats on days 3, 5, 7, 9, 12, 15 and 18 after S-antigen injection. Aqueous dynamics studies were performed on days 0, 3, 7, 14 and 21. Aqueous humor production was measured using an FITC-albumin dilution technique; outflow facility was measured using anterior chamber infusion with constant pressure. RESULTS: IOP decreased to a mean of 16.5 +/- 4.3 mmHg from days 2-5 after S-antigen injections from a mean pre-experimental value of 20.5 +/- 5.4 mmHg. IOP increased from days 6 to 20 (35.8 +/- 9.1 mmHg; P = 0.00001). Histopathologic study revealed inflammation of the anterior and posterior segments from days 9 to 21 after S-antigen injection. Aqueous humor production decreased and outflow facility increased at day 3 after S-antigen injection. At days 7 and 14 after S-antigen injection, acqueous humor production was increased while outflow facility remained normal or was decreased. CONCLUSION: This model of uveitis glaucoma is characterized by three overlapping phases: (1) ocular hypertension, (2) ocular hypertension associated with clinical and histologic inflammation and (3) anatomic sequelae of uveitis and variable IOP. This model permits in vivo studies of mechanisms of IOP change associated with uveitis.

Animals↗

PubMed1994

Krupin disk implantation for complicated glaucomas.

BACKGROUND: The Krupin Eye Valve with Disk (Krupin disk) is a glaucoma shunt that incorporates a slit valve intended to minimize early postoperative hypotony. METHODS: The medical records of all patients who have undergone Krupin disk implantation at the Doheny Eye Institute between July 1990 and December 1992 (25 eyes of 25 patients) were reviewed. RESULTS: Intraocular pressure (IOP) was reduced from a mean of 36.1 +/- 11.5 mmHg to 15.3 +/- 7.5 mmHg at follow-up intervals of 4 to 19 months (mean, 13.2 months). On the first postoperative day, IOPs ranged from 0 to 40 mmHg. In two eyes (8%), the IOP was less than 6 mmHg, and in five eyes (20%) the IOP was more than 21 mmHg. Serous choroidal effusion and/or choroidal hemorrhage occurred in seven patients (28%). Six- and 12-month life-table success rates (6 < or = IOP < or = 21 mmHg) were 84% and 66%, respectively. CONCLUSION: The Krupin disk lowers IOP in most patients; however, the presence of a slit valve does not eliminate either early postoperative hypotony with its attendant complications or early IOP spikes.

Adolescent↗

PubMed1994

Intermediate-term results of a randomized clinical trial of the 350- versus the 500-mm2 Baerveldt implant.

BACKGROUND: The Baerveldt glaucoma implant is a large equatorial aqueous shunting device that is installed through a single-quadrant conjunctival incision. The intermediate-term results of a randomized study comparing the 350- and 500-mm2 Baerveldt implants are reported. METHODS: Seventy-three patients with medically uncontrollable, nonneovascular glaucomas associated with aphakia, pseudophakia, or failed filters were enrolled in a randomized, prospective study comparing 350- and 500-mm2 Baerveldt implants. Surgical success was defined as 6 mmHg < or = final intraocular pressure < or = 21 mmHg without glaucoma reoperation or devastating complication. RESULTS: Of patients with 350- and 500-mm2 implants, 93% and 88%, respectively, achieved surgical success (18-month life-table analysis, P = 0.93). The 500-mm2 implants afforded intraocular pressure control with significantly fewer medications (0.7 versus 1.3; P = 0.006). The postoperative visual acuities remained within one line of the preoperative visual acuities or improved in 62% and 66% of patients in the 350- and 500-mm2 groups, respectively (P = 0.93). Complication rates were statistically similar. The most frequent ones in the 350- and 500-mm2 groups, respectively, were serous choroidal effusion (16% and 32%), strabismus (16% and 19%), anterior uveitis (14% and 11%), and corneal or corneal graft edema (11% each). CONCLUSION: The intermediate-term results of the 350- and 500-mm2 Baerveldt implants were statistically comparable with respect to surgical and visual outcomes, as well as complications, although the larger implant was associated with a higher rate of some complications. However, the 500-mm2 Baerveldt implant afforded intraocular pressure control with fewer medications than the 350-mm2 implant.

Adolescent↗

PubMed1994

Aqueous tube shunt to a preexisting episcleral encircling element in the treatment of complicated glaucomas.

PURPOSE: The treatment of glaucoma after scleral buckling surgery is often problematic. The authors investigated a series of patients in whom a silicone tube was implanted to shunt aqueous from the anterior segment to the fibrous capsule surrounding a previously placed silicone episcleral encircling element. METHODS: Thirteen patients were retrospectively reviewed. In each patient, a silicone tube was inserted through a small incision into the fibrous capsule overlying the scleral explant. In most patients, no attempt was made to secure the distal end of the tube to the silicone band. The proximal end of the tube was inserted into the eye via a needle track. RESULTS: Successful control of intraocular pressure (IOP) (6 mm Hg < or = final IOP or < 21 mmHg with or without medication) was ultimately achieved in 11 (85%) of 13 patients (3 of the successful patients underwent one or more surgical revisions to relieve obstruction of the proximal and/or distal tube opening). Follow-up in these patients ranged from 8 to 49 months (mean +/- standard deviation, 21.7 +/- 14.1 months). The final postoperative visual acuities were within one line of the preoperative visual acuities or had improved in 11 (85%) patients. Complications included serous choroidal detachment (3 patients; 23%), conjunctival wound leak (2 patients; 15%), hyphema (1 patient; 8%), and tube obstruction by lens, iris, vitreous, or episcleral fibrous tissue (4 patients; 31%). CONCLUSION: Aqueous tube shunt to a pre-existing episcleral encircling element is useful in treating complicated glaucomas after scleral buckling surgery. Fibrous obstruction of the external tube opening is a frequent complication in the early postoperative period, but it may be relieved by surgical revision.

Adult↗

PubMed1994

Epithelial ingrowth and glaucoma drainage implants.

BACKGROUND: The authors report four cases of conjunctival epithelial invasion into the fibrous capsule surrounding a Baerveldt glaucoma implant. All cases were associated with concurrent or recent prior scleral buckling surgery. METHODS: Three patients had postoperative conjunctival wound leaks, one in the immediate postoperative period and the other two at 9 and 17 days postoperatively after release of the tube ligature. In the fourth patient, a fistulous tract developed over the implant after a first-stage insertion. Histopathologic confirmation of subconjunctival epithelialization was obtained in two of these patients. RESULTS: Surgical revision was performed in all patients. Excision and debridement of all epithelium-lined subconjunctival tissues and extensive bipolar cautery were used in the three patients with wound leaks. Implant removal also was performed in one of these. Fistulectomy and bipolar cautery were used in the fourth patient. No recurrent wound leaks or other adverse sequelae were noted. CONCLUSIONS: Epithelial invasion of the subconjunctival space and inner bleb wall after implantation of glaucoma drainage devices can lead to breakdown of the conjunctival wound and persistent aqueous leak. Prior or concurrent scleral buckling surgery may predispose to this occurrence. Surgical revision involving epithelial debridement, cautery, and meticulous wound closure, with or without implant removal, has been used successfully in the management of this complication.

Adult↗

PubMed1994

Rhegmatogenous retinal detachment after Molteno glaucoma implant surgery.

BACKGROUND: The Molteno implant is a device used for surgical treatment of complicated glaucoma. Rhegmatogenous retinal detachment (RD) is a relatively rare complication of Molteno implant surgery. This study was undertaken to evaluate the clinical features including the surgical management and postoperative outcome of patients with rhegmatogenous RD after Molteno implant surgery. METHODS: The authors reviewed 350 consecutive patients who had Molteno surgery and identified 16 patients with subsequent rhegmatogenous RD. They also studied one patient referred for RD repair after Molteno surgery at another institution. RESULTS: The risk of rhegmatogenous RD was 5%. Seventy percent (12/17) of the patients presented within 4 months of the Molteno procedure. Dialysis and flap tear were the most common types of retinal break found. Forty-one percent (7/17) of the patients had proliferative vitreoretinopathy. In three patients, clinical features suggested RD resulting from the Molteno procedure. In other patients, previous ocular surgery and underlying ocular disease may have contributed to the development of RD. Retinal detachment repair was attempted in all patients. Among 16 patients with at least 6 months of follow-up, 56% (9/16) had successful retina attachment. Forty-four percent (7/16) of the patients maintained formed vision. Eighteen percent (3/16) of the patients maintained visual acuity of at least 20/40. Intractable glaucoma did not develop in any of the patients with an attached retina. Recurrent RD, endophthalmitis, cyclitic membrane, or intractable glaucoma led to phthisis bulbi or enucleation in 44% (7/16) of the patients. CONCLUSION: A combined approach by vitreoretinal and glaucoma surgeons can restore vision and maintain glaucoma control in patients with rhegmatogenous RD associated with Molteno implant surgery.

Adolescent↗

PubMed1994

Initial clinical experience with the baerveldt implant in complicated glaucomas.

BACKGROUND: The Baerveldt glaucoma implant is an aqueous shunting device with a large surface area that is installed through a conjunctival incision in one quadrant of the eye. This study presents the initial results of the first 13 patients who underwent Baerveldt implantation as part of the Food and Drug Administration approval process. METHODS: Thirteen patients with medically uncontrollable complicated glaucomas underwent one-stage implantation of either a 200- or 350-mm2 Baerveldt implant without postoperative systemic antifibrosis therapy. Surgical success was defined as intraocular pressure greater than or equal to 6 and less than or equal to 21 mmHg without glaucoma reoperation or devastating complication. RESULTS: Eight patients (62%) had successful surgical outcomes, with a mean follow-up of 17.3 +/- 7.0 months (+/- standard deviation) (range, 6-24 months). Seven (70%) of the ten patients with glaucomas associated with aphakia or pseudophakia had successful outcomes, whereas only one (50%) of the two patients with neovascular glaucomas had a successful outcome. One patient with glaucoma associated with nanophthalmos and an unsuccessful filtering procedure had a failed outcome. The postoperative visual acuities remained within one line of the preoperative visual acuities or improved in 62% of the patients. The most frequent complications among all patients were transient serous choroidal effusion (23%) and hyphema (15%). CONCLUSION: Initial results of the Baerveldt implant generally are comparable with other implants. It is easier to install and requires less extensive conjunctival dissection than other large implants. Additional studies are needed to evaluate the effectiveness of the Baerveldt implant in affording long-term intraocular pressure control.

Adult↗

PubMed1994

Glaucoma drainage implants.

Glaucoma drainage implants provide a useful option in the management of complicated glaucomas for which the risk of failure of conventional filtering surgery is high. The basic design of these devices is similar; a silicone tube shunts aqueous humor from the anterior chamber to a fibrous capsule surrounding a synthetic plate or band positioned at the equatorial region of the globe. The capsule serves as a reservoir for aqueous drainage. Drainage implants have been used in the treatment of various refractory glaucomas, including those associated with aphakia and pseudophakia, prior unsuccessful filtering surgery, anterior segment neovascularization, trauma, youth, uveitis, epithelial downgrowth, iridocorneal endothelial syndrome, vitreoretinal disorders, and penetrating keratoplasty. Modifications in implant design and surgical technique have been developed to limit the occurrence of postoperative complications such as hypotony and its related sequelae, and strabismus.

Child↗

PubMed1994

Modification of the glaucoma drainage implant to prevent early postoperative hypertension and hypotony: a laboratory study.

Hypotony or hypertension in the early postoperative period following implantation of a nonvalved seton such as the Molteno tube is a common problem. We conducted a laboratory investigation evaluating two modifications of the silicone drainage tube. One involved a longitudinally-oriented, pressure-sensitive slit-valve combined with an absorbable occluding ligature interposed between the valve and the episcleral plate. Experiments examining the relationship between slit length, opening pressure, and flow rate were performed. The second modification involves focally constricting the lumen of the tube with an external ligature in order to reduce flow rates. Our results indicate that a slit-valve length of 2.0 mm appears to provide a reliable opening pressure of around 10 mm Hg, with relatively high flow when pressures exceed opening pressure. Focally constricting the lumen of the tube, however, was shown to be both unpredictable and unsatisfactory for reducing the flow of fluid to a range consistent with steady state aqueous production.

Drainage↗

PubMed1994

Intraocular pressure in Lewis rats.

PURPOSE: To perform noninvasive measurements of intraocular pressure (IOP) in rats, the Tono-Pen-1 and Tono-Pen-2 were calibrated against direct manometry. Normal values and the long-term fluctuations of IOP in Lewis rats were established. METHODS: For calibration, 24 eyes were cannulated and connected to a pressure transducer with a chart recorder. IOP was increased from 5 to 40 mm Hg in 5 mm Hg increments, and from 40 to 60 mm Hg in 10 mm Hg increments. After each incremental increase, IOP was measured with a Tono-Pen-1 and a Tono-Pen-2 tonometer. To determine normal IOP in Lewis rats, IOP was measured with a Tono-Pen-1 in 229 eyes of 115 rats, and a histogram of normal IOP was established. To ascertain long-term IOP fluctuations, the pressure in 52 eyes of 26 rats was measured every day between 8:30 and 9:30 AM for 7 consecutive days. RESULTS: Plotting the mean Tono-Pen readings for each eye against the transducer IOP produced two regression formulas: y = 1.819 + 0.711 x (r2 = 0.92) for Tono-Pen-1, and y = -1.291 + 0.784 x (r2 = 0.97) for Tono-Pen-2. The normal IOP in rats was 17.30 +/- 5.25 mm Hg (90% confidence interval: 7.28 and 26.98 mm Hg for the lower and upper limits of normal IOP). There was no long-term fluctuation in IOP (P = 0.55). CONCLUSIONS: IOP can be measured accurately in living rats with the Tono-Pen-1 or the Tono-Pen-2.

Animals↗

PubMed1993

Echographic evaluation of glaucoma shunts.

BACKGROUND: It is frequently impossible to determine by clinical examination alone if a filtering bleb is present over the equatorial plate(s) of a glaucoma shunt. This uncertainty can result in management dilemmas when patients with these devices have elevated intraocular pressures (IOPs). The authors describe how standardized echography can be used to determine if fluid is present around the plates and to characterize the blebs. METHODS: Four hundred twenty-seven plates in 269 patients who had undergone single- or double-plate Molteno implantation underwent standardized echography (both A- and B-scan examinations) to determine if blebs were present around the plates, primarily when results of slit-lamp examinations had been inconclusive. Bleb sizes, locations, and characteristics also were evaluated. RESULTS: Sixty-five percent of the plates had associated blebs, which were graded according to their sizes (small, medium, and large, in 29%, 44%, and 27% of plates with blebs, respectively). Fluid (which appeared as an echolucent area) could be seen underlying and/or overlying the plates (which appeared as echodense lines). Larger blebs were often associated with scleral flattening. Although bleb sizes did not necessarily correlate with the levels of IOP control, the presence of a bleb on ultrasound was indicative of tube patency. CONCLUSION: Standardized echography was invaluable in the postoperative management of patients who had undergone Molteno implantation because it demonstrated the presence or absence of blebs and characterized them when results of slit-lamp examinations had been inconclusive. This technique also can be used to evaluate similarly designed aqueous shunting devices.

Adult↗

PubMed1993

Trabeculectomy and Molteno implantation for glaucomas associated with uveitis.

PURPOSE: This study compares the outcomes of trabeculectomy and Molteno implantation in the treatment of glaucomas associated with uveitis. METHODS: Forty-five patients with uveitis, who had undergone filtering surgery for glaucomas associated with uveitis, were reviewed retrospectively. Successful outcome was defined as final intraocular pressure (IOP) of 6 to 21 mmHg, with a minimum follow-up of 6 months without visually devastating complications or loss of light perception. RESULTS: One- and two-year life-table success rates, respectively, were 81% and 73% with trabeculectomy (16 patients); 53% and 31% with combined trabeculectomy and first-stage (reserve) Molteno implantation (19 patients); and 79% and 79% with one-stage Molteno implantation (10 patients). In 11 patients who underwent second-stage Molteno implantation after trabeculectomy failure, 1- and 2-year life-table success rates were 79% and 79%, respectively. Complications included surgically treated choroidal effusions (1/45; 2%), choroidal hemorrhages (3/45; 7%), and chronic hypotony (3/45; 7%). Follow-up in all groups ranged from 5 to 70 months (mean +/- standard deviation, 28 +/- 17 months). CONCLUSIONS: Trabeculectomy provides surprisingly good results in glaucomas associated with uveitis (modulation of wound healing with antimetabolites probably would afford an even higher success rate). However, when significant, immediate postoperative and/or moderate chronic postoperative inflammation is likely, aqueous drainage devices appear more likely to control IOP.

Adult↗

PubMed1993

Incidence and management of glaucoma in Vogt-Koyanagi-Harada syndrome.

BACKGROUND: The Vogt-Koyanagi-Harada syndrome is a bilateral panuveitis associated with neurologic and dermatologic manifestations. METHODS: The authors reviewed the charts of all patients with Vogt-Koyanagi-Harada syndrome seen at their institution over the past decade to determine the incidence of glaucoma, as well as the results of medical and surgical therapy for glaucoma, in this group of patients. FINDINGS: Of 42 patients diagnosed with Vogt-Koyanagi-Harada syndrome, evidence of glaucoma requiring either medical or surgical intervention occurred in 16 patients (38.1%). Of these, nine (56.3%) had open-angle glaucoma and seven (43.7%) had angle-closure secondary to pupillary block. In 5 (31.3%) of the 16 patients, medical therapy alone was sufficient to control intraocular pressure. Eleven patients (68.7%) required surgical intervention, consisting of laser iridotomy, surgical iridectomy, trabeculectomy with or without 5-fluorouracil, and/or Molteno implantation. CONCLUSION: The relative success of each of these procedures in this group of patients is discussed. Glaucoma is a common complication in the Vogt-Koyanagi-Harada syndrome, and one that is often difficult to control.

Adolescent↗

PubMed1993

Mitomycin-C concentration in human aqueous humour following trabeculectomy.

The aim of the study was to determine mitomycin-C (MMC) concentrations in human aqueous humour during trabeculectomy and to correlate anterior chamber concentrations with method of application. MMC was applied intra-operatively by saturating sponges, ranging in size from 2 x 2 x 5 mm to 2 x 4 x 10 mm on dry cut, with 0.5 mg/ml MMC during trabeculectomy for 3-5 minutes. Applications to episclera were made in 18 cases and to the scleral bed after scleral flap dissection in 9 cases. Aqueous samples were collected by paracentesis with a 30 gauge needle 2-7 minutes after removal of sponge and external irrigation. Aqueous MMC concentrations were determined by high-performance liquid chromatography. Aqueous MMC concentration in 27 samples ranged from below minimum detectable concentration (less than 5 ng/ml) to 120.8 ng/ml. Mean aqueous drug levels obtained when the applications were to the scleral bed were 35.65 +/- 39.17 ng/ml (range 5-120.8 ng/ml). Applications on episclera gave mean aqueous concentrations of 4.98 +/- 9.11 ng/ml (range 0-33.3 ng/ml). The difference was statistically significant (p = 0.004). There were no correlations between sponge size, time of MMC exposure and aqueous MMC level. In conclusion, MMC is detectable in aqueous humour within minutes of external application and the aqueous concentration level is higher if the application is in the scleral bed than on the episclera. Toxicity of the drug at this concentration range for corneal endothelial cells needs further investigation via in vitro and clinical studies.

Adolescent↗

PubMed1992

Incidence and management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments.

BACKGROUND: Intravitreal silicone oil injection used for managing complicated retinal detachments can be associated with elevated intraocular pressure (IOP). This study was undertaken to determine the incidence of glaucoma in patients who underwent silicone oil injection, as well as to evaluate the effectiveness of medical and surgical therapy in patients in whom glaucoma developed. METHODS: The postoperative courses of 50 eyes of 47 consecutive patients who underwent pars plana vitrectomy and silicone oil injection for the management of complicated retinal detachments were reviewed retrospectively. The outcomes of patients who underwent silicone oil removal and/or glaucoma surgery also were evaluated. RESULTS: The mean overall postoperative IOP before any glaucoma surgery was 16.7 +/- 9.3 mmHg (range, 0 to 45 mmHg), with a mean follow-up of 16.6 +/- 12.1 months (range, 2 to 51 months). Twenty-four (48%) eyes had postoperative IOPs of at least 25 mmHg and IOP elevations of at least 10 mmHg above the preoperative levels. Twenty-one (42%) eyes underwent complete removal of silicone oil and/or glaucoma surgery to effect IOP control. The IOPs were controlled to 21 mmHg or less (but > 5 mmHg) in 8 of 14 eyes that underwent removal of silicone oil alone, in 3 of 5 eyes that underwent Molteno implantation, and in 1 eye that underwent Nd:YAG transscleral cyclophotocoagulation, but not in 1 eye that underwent a modified Schocket procedure (mean follow-up, 13.5 +/- 11.0 months; range, 0.2 to 33 months). CONCLUSION: Intraocular pressure elevation is a common occurrence after intravitreal silicone oil injection. The underlying mechanism may often be multifactorial in nature. Patients in whom uncontrolled IOP develops may benefit from aggressive medical and/or surgical treatment with silicone oil removal, glaucoma implants, or cyclodestructive procedures.

Adolescent↗

PubMed1992

Which is better? One or two? A randomized clinical trial of single-plate versus double-plate Molteno implantation for glaucomas in aphakia and pseudophakia.

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Adolescent↗