®

185 mm2 Glaucoma implant

Smaller footprint, yet clinically demonstrated to be:• As effective as Baerveldt® 250 mm2 implant

in short and long term reduction of IOP1

• Equally as effective as the larger Molteno3®

245 mm2 implant2

Smaller size - more implant placement options3:• Single quadrant placement

• Sub, intra, and supra-Tenon’s placement options

Easier access for suturing:• Anterior hole suture placement

Easier placement of the plate:• Lower profile ridge with streamlined

contour and edge detail

Simplified closure:• Reduced angle profile

Smaller plate — more surgical options

185 mm2 Glaucoma implant

Pressure ridge mechanics:

Designed to confine aqueous to the primary drainage space:• Reduces hypotony in cases where immediate drainage is required

• Initial function similar to a drainage implant but with a small surface area

• Reduced complications from excessive early filtration

Aqueous filters through the bleb lining in the primary drainage area: • Stimulates collagen deposition

• Impedes flow of aqueous resulting in pressure rise in primary drainage area

• Combined effect creates intolerable environment for fibroblasts

• Fibroblast apoptosis releases potent mediators and triggers a cascade ofanti-fibrotic effects4,5

Gradual increase in pressure elevates the tissues over the ridge:• Aqueous infused with anti-fibrotic mediators flows into main bleb

• Anti-inflammatory properties and collagen degradation promotes a permeable blebover the long-term

About bleb management:

Pressure ridge: • Used together with tube ligation

• Intended to assist the process of bleb management

Pressure ridge is positioned under posterior Tenon’s capsule: • Establishes a dynamic two stage bleb

• Moderates the effects of hypotensive and hypertensive stages of bleb formation

Absorbable ligating suture dissolves or is released manually: • Aqueous releases into the pre-formed bleb system

• Designed to reduce the risk of hypotony6,7,8

Venting the tube with “Sherwood” slits: • Allows aqueous to drain under the patch graft prior to dissolution of ligating suture

• Facilitates the development of a pre-formed tissue capsule

®

Surface Area of Plate = 185mm2

Description Item #

185 mm2 M3-185 245 mm2 M3-245

Description Item #

Mini Westcott Scissors K4-3200

Fechtner Conjunctiva Forceps K5-1820

Diamond Step Knife - 10 facet K2-6548

Tennant Tying Forceps, straight K5-5220

Tennant Tying Forceps, curved K5-5230

Barraquer Needle Holder, curved K6-3310

Tissue Description Item #

Pericardium 1.5 x 1.5cm 68250

Sclera 0.5 x 0.8cm 68333

Clear Cornea 1/3 Cornea 68329

Ordering information

Surgical instruments

1Patel, SachiR., Silverman, Anna, Patel, Shamil, Reiss, George (February 2015). Comparison of Surgical Outcomes of the Molteno 185mm2 Shunt and the Baerveldt 250mm2 Shunt: Is there a difference? Poster session presented at the Annual Meeting of the American Glaucoma Society, Coronado, CA 2Patel, SachiR., Silverman, Anna, Patel, Shamil, Reiss, George (February 2015). Comparison of Surgical Outcomes of the Molteno 185mm2 Shunt and the Molteno 245mm2 Shunt: Is there a difference? Poster session presented at the Annual Meeting of the American Glaucoma Society, Coronado, CA 3Freedman J, Bhandari R., Supra-tenon capsule placement of original Molteno vs Molteno3® tube implants in black patients with refractory glaucoma: a single-surgeon experience. Archives of Ophthalmology 2011 Aug;129(8):993-7. doi: 10.1001/archophthalmol.2011.183 4Molteno AC, Fucik M, Dempster AG, Bevin TH. Otago Glaucoma Surgery Outcome Study: factors controlling capsule fibrosis around Molteno implants with histopathological correlation. Ophthalmology. 2003 Nov;110(11):2198-206. 5Molteno AC, Bevin TH, Dempster AG, Devereux F. Otago Glaucoma Surgery Outcome Study: Further Histology and Immunohistochemistry of Molteno Implant Blebs. Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4364-746Valimaki JO, Ylilehto AP. Molteno3® Implantation as Primary Glaucoma Surgery. J Ophthalmol. 2014;2014:167564. 7ValimakiJ. Surgical management of glaucoma with Molteno3® implant. J Glaucoma. 2012 Jan;21(1):7-11. 8Sherwood MB, Smith MF. Prevention of early hypotony associated with Molteno implants by a new occluding stent technique. Ophthalmology. 1993 Jan;100(1):85-90

Molteno® and Molteno3® are registered trademarks of Molteno® Ophthalmic LTDTutoplast® is a registered trademark of Tutogen MedicalBaerveldt® is a registered trademark of Abbott Medical Optics

Tutoplast®-The patch graft standard for:

• Drainage implant and/or valve implantation• Repair of leaking and/or overfiltering bleb• Repair of corneo-scleral fistulas

SS073-16A

®

800-225-1195 • www.katena.com

Molteno3® Glaucoma Implant

For more information, or to place an order, contact your local representative.