Management of the Molteno Silicone Tube in Corneal Transplant Surgery

A method to prevent tube-corneal touch in patients with Molteno implants who require corneal transplants is presented. A double-armed 10-0 Prolene suture is passed from limbus to limbus so that within the anterior chamber the suture acts as a splint for the silicone tube of the Molteno implant, keeping it away from the cornea. This suture has been used in six patients, all aphakic or pseudophakic, requiring corneal transplants for bullous keratopathy. In all six patients, the silicone tube was successfully splinted away from the endothelium of the corneal transplant.