A patient with adult onset diabetes with retinopathy (which had been managed by retinal photocoagulation) developed neovascular glaucoma shortly after cataract extraction at the age of 59 years. His right eye was drained by trabeculectomy, which failed and became phthisical. Subsequently, his left eye was drained by Molteno® Implant. Preoperatively his cornea was cloudy and the IOP was 24-38 mmHg on timolol, epinephrine and acetazolamide. At operation a Pressure Ridge Single Plate Molteno® Implant (D1) was inserted for immediate drainage to prevent further loss of vision. The operation cleared the cornea sufficiently for additional retinal photocoagulation. Following the operation his IOP was controlled on Timolol. Four years later the IOP rose and was treated by further retinal photocoagulation. At the time of his death 5 years after operation he had useful vision with an acuity of 6/18 (20/60) and an IOP of 12-17 mmHg. Surgeon: ACB Molteno, M.D. FACS.