June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Real-world outcomes following Paul Glaucoma Implant (PGI) surgery
Author Affiliations & Notes
  • Constance Weber
    Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Raffael Liegl
    Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Frank G Holz
    Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Karl Mercieca
    Ophthalmology, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  • Footnotes
    Commercial Relationships   Constance Weber None; Raffael Liegl None; Frank Holz None; Karl Mercieca None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3695 – A0380. doi:
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      Constance Weber, Raffael Liegl, Frank G Holz, Karl Mercieca; Real-world outcomes following Paul Glaucoma Implant (PGI) surgery. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3695 – A0380.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Glaucoma is one of the leading causes of irreversible blindness worldwide. Drainage devices are among the most popular surgical procedures to lower intraocular pressure (IOP) in order to prevent glaucoma progression. The Paul Glaucoma Implant (PGI) is an innovative device with a smaller size and internal diameter compared to more “traditional” tubes such as the Ahmed and Baerveldt. It was developed to overcome typical drawbacks of these tubes, including early failure in the former and post-operative hypotony and delayed function in the latter. In theory, a smaller tube should also result in reduced corneal endothelial cell loss over time. This large descriptive case series shows the one-year results of the very first patient cohort receiving a PGI in Germany.

Methods : A prospective database of patients undergoing PGI implantation at the University Eye Hospital in Bonn was created in a Microsoft Excel spreadsheet. Data of preoperative and follow-up visits have been collected until now and the database is continuously updated at every visit. Major outcomes were IOP, number of glaucoma medication, best corrected visual acuity (BCVA), visual field results, corneal endothelial cell count and complications. Statistics were obtained with SPSS statistics for Windows.

Results : A total of 60 eyes from 58 patients were included. The mean review period was 8 months (range from 1-13 months). The mean IOP at baseline was 26 mmHg. The PGI led to a mean IOP reduction of 64%. The mean IOP was 9 mmHg at 6 weeks, 11 mmHg at 3 months and 12 mmHg at 6 months postoperatively. Complication rates were low, with 5% (n=3) of patients having a temporary hyphema postoperatively whilst another 5% (n=3) developed a numerical hypotony postoperatively that resolved without an additional intervention. Only 3 % (n=2) needed topical glaucoma medication at six months postoperatively.

Conclusions : The PGI is a safe and effective new glaucoma drainage device that reduces IOP effectively with a low complication rate. Thus, it represents an innovative new treatment modality. Further studies are necessary to evaluate its long-term effect.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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