Fig. 4. Placement of Molteno double-plate reservoirs. After the superior half of the sclera is exposed with limbal peritomy, the superior rectus muscle is isolated. A 4-0 silk suture is placed to rotate the globe downward. If the interconnecting tube is to be placed underneath the rectus muscle, the second plate must be pulled underneath the rectus muscle insertion. Alternatively, the plates can be placed in the superotemporal and superonasal quadrants, leaving the interconnecting tube over the rectus muscle. The plates are secured at least 8 mm from the limbal site.