Abstract
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Objectives: To evaluate the efficacy and outcomes of the first 130 cases of Paul Glaucoma Implant (PGI) in Ireland between 2020 to 2024. This represents the largest analysis of glaucoma drainage devices in Ireland to date.
Methods: This is a retrospective comparative analysis of 130 patients that underwent PGI surgery at the Mater Misericordiae University Hospital, Royal Victoria Eye and Ear Hospital from January 2019 to December 2024 and University Hospital Galway 2023-2024.
The primary outcome was surgical success based on predefined IOP criteria (A ≤ 21, B ≤ 18, C ≤ 15, and D ≤ 12 mmHg). Success is characterized as qualified if achieved with ocular hypotensive medications and complete without medication. Failure was determined by an IOP level measured above the upper limit or below the lower limit of 6 mmHg on two consecutive visits or loss of light perception attributable to glaucoma. Secondary outcomes included reduction in IOP-lowering medications, maintenance of BCVA, complications, visual field progression over an extended follow up of 5 years.
Results: Across three centres (MMUH, RVEEH, UHG) a total of 130 charts were reviewed. 104 were included in analysis based on inclusion criteria. At 12 months complete success was achieved in 27.9% and qualified in 51%. Kaplan Meier analysis demonstrated 75.8% survival at 36 months.
Initial results show a marked reduction in mean IOP at 12 months (P<0.0001) (16.77±1.18). The mean IOP was 13.12±4.16 with a significant mean reduction (16.77±1.18, P<0.0001) at 12 months. Mean reduction in drops was PGI -2.06 at 12 months.
Conclusion: As a novel device, our findings show the PGI is an effective surgical intervention with up to 5 year data for the management of medially refractive glaucoma compared to its predecessors.
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