Molteno Implant

Molteno implant

The Molteno implant is one of the original glaucoma drainage devices, designed to lower eye pressure by diverting fluid from inside the eye to a plate placed under the outer tissue of the eye. It consists of a small tube attached to a silicone plate; the tube carries fluid to the plate, where a reservoir forms and the fluid is absorbed into surrounding tissue. Because it is a non-valved device, surgeons often use temporary sutures or other techniques to slow flow at first and prevent pressure from falling too low right after surgery. This implant is commonly used for eyes with advanced or refractory glaucoma—cases where medications and other surgeries have not worked or are not suitable. The device has a long track record and can provide sustained pressure control, which helps protect the optic nerve and preserve vision. Complications can include scarring around the plate that reduces effectiveness, tube exposure, infection, or too-low pressure, so careful follow-up is important. Sometimes additional surgeries or adjustments are needed if the device stops working as well as expected. The Molteno’s design and surgical technique influence how quickly it works and how durable the pressure reduction is. For many patients with difficult-to-control glaucoma, it remains a valuable option that can significantly reduce the risk of further vision loss.