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Objective This study was undertaken in Otago, New Zealand, to provide data on the long-term results of cases of uveitis with secondary glaucoma drained by Molteno implants. Design A prospective, noncomparative case series of all cases of chronic uveitis with secondary glaucoma drained by Molteno implants from 1978 through 1998. Participants Forty eyes of 35 patients. Intervention Insertion of Molteno implant. Main outcome measures Intraocular pressure, visual acuity, and progressive visual field loss. Results Insertion of a Molteno implant was effective in controlling the intraocular pressure at 21 mmHg or less with a probability of 0.87 (95% confidence interval [CI], 0.76, 0.98) and 0.77 (95% CI, 0.60, 0.93) at 5 and 10 or more years after surgery. The mean visual acuity improved from 20/100 to 20/70 immediately after operation. This value declined to 20/130 at 5 and 10 years after surgery and then improved slightly to 20/120 at 15 years after surgery. In these eyes, the Kaplan-Meier estimated probability of retaining useful vision (visual acuity >20/400; visual field >5° radius) was 0.75 (95% CI, 0.61, 0.89) and 0.71 (95% CI, 0.55, 0.87) at 5 and 7 or more years after surgery. Conclusions The insertion of a Molteno implant controlled the intraocular pressure in 76% of cases over the follow-up period. Patients in whom the uveitis was well controlled maintained their visual acuity and visual fields, whereas the proportion of cases requiring steroids and the doses required fell progressively over the period of follow-up. Failures were related to complications of advanced disease, previous intraocular surgery, and failure to control the uveitis. The drainage system provided by the Molteno implant proved robust, continuing to function well despite continuous activity of the uveitis, acute exacerbations of the uveitis, and all subsequent intraocular surgery including cataract extraction, keratoplasty, and vitrectomy.

To compare the effect of using the fingertip of a surgical glove over Ocufilm (Reichert Technologies, NY, USA) on the agreement and reproducibility of measuring intra-ocular pressure (IOP) by the Tono-Pen XL (Reichert Technologies, NY USA).Experimental, clinical study.Patients were randomized into two groups to receive IOP measurements using Tono-Pen XL with two different types of tip covers. In Group 1, the IOP of the right eyes were first measured using Ocufilm as the tip cover followed by using the fingertip of a surgical glove. As for the left eyes, the tip of the surgical glove was used first, followed by use of Ocufilm. In Group 2, the IOP of the right eyes was first measured using the tip of the surgical glove,followed by use of Ocufilm, while for the left eye the latter was used first, followed by the tip of the surgical glove. A single operator measured the IOP in each eye twice using each type of tip cover. Agreement between the Tono-Pen XL measurements using the two different tip covers was analyzed using the Bland-Altman analysis. The difference between the repeated measures was assessed for reproducibility of the Tono-Pen XL measurements with regard to each type of tip covers.100 patients (200 eyes) were recruited into the present study. The mean difference of IOP taken by the Tono-Pen XL covered with Ocufilm and the fingertip of a surgical glove was -0.21 mmHg (95% CI: -0.36 to -0.05). The limits of agreement (confidence interval 95%) as calculated by the Bland-Altman plots for Ocufilm-Fingertip of a surgical glove was -2.43 to +2.02 mmHg. The coefficient of repeatability of the Ocufilm vs. the surgical glove was nearly the same (1.74 vs. 2.37, respectively).A significant agreement exists between using Ocufilm and the fingertip of a surgical glove to cover the tip of a Tono-Pen XL for measuring IOP The coefficient of repeatability was comparable between the two different types of tip covers. When measuring IOP the tip of a Tono-Pen XL could therefore be covered by either Ocufilm or the fingertip of a surgical glove without compromising accuracy.