International Ophthalmology

, Volume 27, Issue 6, pp 345–350 | Cite as

Primary single-plate Molteno tube implantation for management of glaucoma in children with Sturge-Weber syndrome

  • Heydar Amini
  • Mohammad Reza Razeghinejad
  • Bahare Esfandiarpour
Original Paper



To evaluate the safety and efficacy of primary single-plate Molteno tube implantation in the management of childhood glaucoma associated with Sturge-Weber syndrome.

Patients and methods

Nine eyes of seven patients were included in this prospective case series. Success was defined as intraocular pressure (IOP) ≤22 mmHg with (relative success) or without (absolute success) glaucoma medications. Intra- and postoperative complications were also evaluated.


Mean age at the time of the surgery was 9.6 ± 3.7 years (range: 5–17 years) and mean follow-up duration was 32 ± 4.7 months (range: 20–36 months). Mean IOP was reduced from 34.2 ± 8.3 mmHg preoperatively to 21.2 ± 7.3 mmHg at the final follow-up (P = 0.012). The number of anti-glaucoma medications was reduced from 3.4 ± 0.5 preoperatively to 2.2 ± 1.3 at the final follow-up (P = 0.058). The cumulative probability of relative success was 97.2% [95% confidence interval (CI): 91.85–100%] at 12 months, 78.02% (95% CI: 60.36–95.67%) at 24 months and 43.34% (95% CI: 16.18–70.5%) at the final follow-up. During the first 6 months after surgery, two patients had controlled IOP without the use of medications (absolute success); however, 6 months and later no eye had achieved absolute success. There were no intraoperative complications. Postoperative complications included choroidal effusion necessitating drainage in three eyes (33.3%), cataract formation in one eye (11%) and retinal detachment in one eye (11%). At the final follow-up, visual acuity was unchanged from preoperative values in five eyes (55.5%); no eye demonstrated visual improvement.


Outcomes of this small case study reveal that primary single-plate Molteno tube implantation appears to be associated with a limited success rate and a relatively high complication rate in eyes of children with glaucoma resulting from Sturge-Weber syndrome.


Glaucoma Molteno tube Sturge-Weber syndrome 



Intraocular pressure


Non-penetrating deep sclerectomy


Sturge-Weber syndrome


  1. 1.
    Weiss JS, Ritch R (1996) Glaucoma in phakomatoses. In: Ritch R, Shields MB, Krupin T (eds). The glaucomas, 2nd edn. Mosby, St LouisGoogle Scholar
  2. 2.
    Font RL, Ferry AP (1972) The phakomatoses. Int Ophthalmol Clin 12:1–50PubMedCrossRefGoogle Scholar
  3. 3.
    Hoskins HD Jr, Shaffer RN, Hetherington J (1984) Anatomic classification of the developmental glaucomas. Arch Ophthalmol 102:1331–1336PubMedGoogle Scholar
  4. 4.
    Mandal AK (1999) Primary combined trabeculotomy–trabeculectomy for early-onset glaucoma in Sturge-Weber syndrome. Ophthalmology 106:1621–1627PubMedCrossRefGoogle Scholar
  5. 5.
    Iwach AG, Hoskins HD Jr, Hetherington J Jr et al. (1990) Analysis of surgical and medical management of glaucoma in Sturge-Weber syndrome. Ophthalmology 97:904–909PubMedGoogle Scholar
  6. 6.
    Keverline PO, Hiles DA (1976) Trabeculectomy for adolescent onset glaucoma in Sturge-Weber syndrome. J Pediatr Ophthalmol 13:144–148PubMedGoogle Scholar
  7. 7.
    Audren F, Abitbol O, Dureau P et al. (2006) Non-penetrating deep sclerectomy for glaucoma associated with Sturge-Weber syndrome. Acta Ophthalmol Scand 84:656–660PubMedCrossRefGoogle Scholar
  8. 8.
    Hamush NG, Coleman AL, Wilson MR (1999) Ahmed glaucoma valve implant for management of glaucoma in Sturge-Weber syndrome. Am J Ophthalmol 128:758–760PubMedCrossRefGoogle Scholar
  9. 9.
    Budenz DL, Sakamoto D, Eliezer R et al. (2000) Two-staged Baerveldt glaucoma implant for childhood glaucoma associated with Sturge-Weber syndrome. Ophthalmology 107:2105–2110PubMedCrossRefGoogle Scholar
  10. 10.
    Gressel MG, Heuer DK, Parrish RK II (1984) Trabeculectomy in young patients. Ophthalmology 91:1242–1246PubMedGoogle Scholar
  11. 11.
    Ali MA, Fahmy IA, Spaeth GL (1990) Trabeculectomy for glaucoma associated with Sturge-Weber syndrome. Ophthalmic Surg 21:352–355PubMedGoogle Scholar
  12. 12.
    Morlet N, Goldberg I (1993) Sturge-Weber syndrome and secondary glaucoma. Aust NZ J Ophthalmol 21:271–272PubMedGoogle Scholar
  13. 13.
    Sidoti PA, Belmonte SJ, Liebmann JM et al. (2000) Trabeculectomy with mitomycin-C in the treatment of peadiatric glaucomas. Ophthalmology 107:422–429PubMedCrossRefGoogle Scholar
  14. 14.
    Cadera W, Pachtman MA, Cantor LB et al. (1984) Filtering surgery in childhood glaucoma. Ophthalmic Surg 15:319–322PubMedGoogle Scholar
  15. 15.
    Wagner RS, Caputo AR, Del Negro RG et al. (1988) Trabeculectomy with cyclocryotherapy for infantile glaucoma in the Sturge-Weber syndrome. Ann Ophthalmol 20:289–295PubMedCrossRefGoogle Scholar
  16. 16.
    Van Emelen C, Goethals M, Dralands L et al. (2000) Treatment of glaucoma in children with Sturge-Weber syndrome. J Pediatr Ophthalmol Strab 37:29–34Google Scholar
  17. 17.
    Billson F, Thomas R, Aylward W (1989) The use of two-stage Molteno implant in developmental glaucoma. J Pediatr Ophthalmol Strab 26:3–8Google Scholar
  18. 18.
    Munoz M, Tomey KF, Traverso C et al. (1991) Clinical experience with the Molteno implant in advanced infantile glaucoma. J Pediatr Ophthalmol Strab 28:68–72Google Scholar
  19. 19.
    Melamed S, Cahane M, Gutman I et al. (1991) Postoperative complications after Molteno implant surgery. Am J Ophthalmol 111:319–322PubMedGoogle Scholar
  20. 20.
    Brodway DC, Iester M, Schulzer M et al. (2001) Survival analysis for success of Molteno tube implant. Br J Ophthalmol 85:689–695CrossRefGoogle Scholar
  21. 21.
    Waterhouse WJ, Lloyd MA, Dugel PU et al. (1994) Rhegmatogenous retinal detachment after Molteno glaucoma implant surgery. Ophthalmology 101:665–671PubMedGoogle Scholar
  22. 22.
    Nesher R, Sherwood MB, Kass MA et al. (1992) Molteno implant in children. J Glaucoma 1:228–232PubMedGoogle Scholar
  23. 23.
    Hill RA, Heuer DK, Baerveldt G et al. (1991) Molteno implantation for glaucoma in young patients. Ophthalmology 98:1042–1046PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Heydar Amini
    • 1
  • Mohammad Reza Razeghinejad
    • 2
  • Bahare Esfandiarpour
    • 3
  1. 1.Department of Ophthalmology, Farabi Eye Hospital and Eye Research CenterTehran University of Medical SciencesTehranIran
  2. 2.Department of Ophthalmology, Khalili Hospital and Poostchi Eye Research CenterShiraz University of Medical SciencesShirazIran
  3. 3.Eye Research CenterTehran University of Medical SciencesTehranIran

Personalised recommendations