Predictive factors for the success of the Paul glaucoma implant: a one-year multicenter prospective study
Year: 2025
Type: article
Abstract: The Paul Glaucoma Implant (PGI) is becoming increasingly used in many countries. The primary aim of this study was to identify the most important pre-, intra- and post-operative factors associated with successful intraocular pressure (IOP) control at one year. A total of two hundred and fifty -one eyes from 239 glaucoma patients undergoing PGI surgery were included in this prospective, multicentre, longitudinal study. Clinical data were collected on a REDCap platform using a standardised surgical protocol. Variables were recorded pre-, intra- and postoperatively. Univariable and multivariable logistic regression were used to identify predictors of complete success at one year. These results are expressed as Odds Ratios (OR) and their 95% confidence intervals (95% CI). Kaplan-Meier survival analysis was also performed. Mean IOP was significantly reduced from 25.3 ± 8.8 mmHg preoperatively to 13.1 ± 3.9 mmHg at one year (p < 0.001). The medication burden decreased from 3.03 ± 1.12 to 0.78 ± 0.96 (p < 0.001). Most complications were minor and self-limiting. Factors associated with complete success in univariable or multivariable analysis were: use of intraoperative antimetabolites (mitomycin or 5-fluorouracil) [OR 2.59; 95% CI 1.18-5.67], combined phacoemulsification-PGI surgery [OR 4.38; 95% CI 1.10-17.36] and removal of the ripcord after 4-5 months [OR 2.36; 95% CI 1.07-5.18]. High myopia was only associated in the univariable analysis (OR 0.50; CI 0.30-0.85; p = 0.010). Previous glaucoma surgery, hypertensive phase, surgeon experience and diagnosis of non-open angle glaucoma were not significantly associated with complete success. This study concluded that the effectiveness of the PGI can be enhanced by implementing certain strategies that have not shown similar benefits in Ahmed or Baerveldt glaucoma devices.
Source: Scientific Reports
Authors: Elena Millá, Javier Moreno-Montañés, Susana Duch, Aitor Lanzagorta, Jesús Téllez, José Vicente Piá, Elena Arrondo, Jorge Vila, Alfonso Antón, Javier Bóveda, Jordi Loscos, The Spain’ Paul Glaucoma Implant Group (SPGG), Francesc Franquesa-Garcia, Mercè Perramon, Remei Hurtado, María Jesús Chaves-Samaniego, Lucía Rial Álvarez, Cristina Irigoyen, Miguel Naveiras, Miriam de la Puente, Angelica de Freytas, José Belda, Carlos Arciniegas, Elena Ávila, Emma Ausín, Teresa Colas, Marta Castany, Jaume Rigo Quera, Julian García-Feijoo, José Mª Martínez de la Casa, Lucía Perucho, Marina Brocal Sánchez, Noelia Druetta, Natalia Olmo, Susana Perucho Martínez, Daniel Gómez Plaza, Julia Barreiro Honrado, Martín González Vázquez
Institutions: Hospital Clínic de Barcelona, Universitat de Barcelona, Clinica Universidad de Navarra, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Instituto de Microcirugía Ocular, Universitat de València, Hospital Universitari i Politècnic La Fe, Universitat Internacional de Catalunya, Institut Català de Retina, Complejo Hospitalario de Pontevedra, Hospital Universitari Germans Trias i Pujol, Miranza, Hospital Quirón Torrevieja, Hospital de Manises, Hospital Universitario Infanta Leonor, Vall d'Hebron Hospital Universitari, Hospital Clínico San Carlos, Hospital Universitario Son Espases, Complejo Hospitalario de Jaén, Hospital Universitario de Fuenlabrada
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W4415786677