Capsule excision after failed Molteno surgery.

BACKGROUND AND OBJECTIVES: To determine the frequency of scar tissue formation requiring surgical intervention after single-plate Molteno implantation and the outcome of excision of the encapsulated bleb. PATIENTS AND METHODS: A retrospective study was performed on 95 eyes of 79 consecutive patients who underwent a single-stage Molteno implantation for refractory glaucoma. Fourteen eyes of 12 patients developed an encapsulated bleb. A successful outcome after bleb excision was defined as final intraocular pressure (IOP) between 6 and 22 mm Hg with the same amount of medication as preoperatively or less. RESULTS: At the end of the mean follow-up of 30 months (range 8 to 75), the mean IOP (19.7 +/- 3.8 mm Hg) after bleb excision was significantly lower than the preoperative IOP (35.2 +/- 10.1 mm Hg; P < .001). The overall conventional success rate was 75%. CONCLUSION: Excision of the encapsulated Molteno bleb offers an alternative in severely damaged eyes that have undergone several surgical procedures.