ACHIEVE CONSISTENT, LONG-TERM IOP CONTROL IN CASES OF SEVERE AND COMPLEX GLAUCOMA WITH THE MOLTENO3® GLAUCOMA DRAINAGE DEVICE

Implanted in thousands of patients worldwide, the Molteno3® Glaucoma Drainage Device has been clinically validated to deliver consistent, long-term reduction in intraocular pressure (IOP) in cases of severe or complex glaucoma. It has also been shown to offer the benefit of improved practice efficiency.

MOLTENO3® IS DESIGNED FOR CONSISTENT IOP REDUCTION

The Molteno3® has demonstrated consistent success rates in a range of severe and complex glaucoma patients, including POAG, PEXG, NVG and uveitic glaucoma.

Over a three-year follow-up period, Molteno3® deployed as a primary surgical option achieved a high rate of success at 91%. Failure was defined as IOP >21, IOP reduction ≤ 5mmHg or IOP reduction <20% reduction at two consecutive visits after three months’ follow-up, reoperation for glaucoma or loss of light perception.

MOLTENO3® IS DESIGNED TO ENHANCE CLINICAL OUTCOMES AND OPTIMIZE SURGICAL UTILITY

The novel design elements of the Molteno3 enable it to achieve the same clinical outcomes as larger plate alternatives via a shorter, simplified surgical procedure. With a contoured plate that measures just 185 mm2, the Molteno3® occupies less scleral real estate and requires less manipulation of the extraocular muscles.

MOLTENO3® FEATURES A SMOOTH POLYPROPYLENE PLATE FOR REDUCED FIBROSIS

The smooth surface texture of the Molteno3 polypropylene plate may reduce the risk of immune responses that negatively affect the filtering bleb2 – and thus safeguard against bleb encapsulation.

In an evaluation of cell cultures in vitro by Hong et al, the Molteno3 demonstrated 20 times less fibroblast cell adhesion as compared to the Ahmed® FP7 plate (100 ±24 cells versus 5 ± 1 cells), and 3 times less fibroblast cell adhesion as compared to the Baerveldt® (15 ± 3 cells versus 5 ± 1 cells).2 These findings are corroborated in clinical practice, with the Molteno3® recording one of the industrys lowest rates of bleb encapsulation at 20%.

SLIMLINE, CONTOURED MOLTENO3® PLATE SIMPLIFIES INSERTION

At just 0.4mm the Molteno3 is the slimmest plate on the market and slides easily between the tissue planes – there is no need to dissect muscles or to use muscle hooks during insertion. This slimline design may also reduce the risk of diplopia: the Molteno3® has one of the lowest reported rates of diplopia at 1%.7,8 As an added benefit, the contoured design of the Molteno3® plate is designed to hug the sclera without riding forward.

MOLTENO3® IS DESIGNED TO CREATE A LIFELONG FUNCTIONING BLEB

The Molteno3® employs a two-stage process of bleb formation. Comprising delayed drainage and a proprietary Primary Drainage Area, the Molteno3® is designed to initiate a sequence of cellular changes that enhance bleb structure.

1. Delayed Drainage

Using a Vicryl® Tie, delayed drainage prevents the initial flow of aqueous from reaching the Molteno3® plate during the early stages of bleb formation and thus allows sufficient time for a thin layer of collagen to form around the plate. It also avoids exposure of the Molteno3® plate to inflammatory cells, cytokines, and proteins resulting from the surgery, thereby preventing the development of a thick layer of fibrosis in the early phases of bleb formation.

2. Primary Drainage Area

Once the Vicryl® tie dissolves, the flow of aqueous commences but is initially restricted to the Primary Drainage Area.

As more aqueous enters the Primary Drainage Area, there is an increase in pressure. The IOP continues to rise until it is higher than episcleral venous pressure. At this point, aqueous displaces extracellular fluid within the Primary Drainage Area and the cells are immersed in aqueous. This triggers a more intense, and early, process of apoptosis.

As the IOP increases the tissues lift off the rim of the Primary Drainage Area and aqueous infused with pro-apoptotic factors flows from the Primary Drainage Area to the Secondary Drainage Area.

A thin, permeable long-term bleb forms around the Secondary Drainage Area.