One-Year Outcomes of the PAUL Glaucoma Implant Compared With the Ahmed Glaucoma Valve for the Treatment of Silicone Oil Glaucoma

Abstract

Précis: Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures. Objective: To evaluate the outcomes of the PAUL glaucoma implant (PGI) and Ahmed glaucoma valve (AGV) in patients with secondary glaucoma caused due to silicone oil emulsification. Patients and Methods: A retrospective examination was conducted using the medical records of 36 patients who developed secondary glaucoma due to silicone oil emulsification after vitreoretinal surgery and then underwent PGI and AGV implantation surgery. The main outcome measures in the PGI and AGV groups were intraocular pressure (IOP) and its change, the number of antiglaucoma medications, and postoperative complications during the 12-month follow-up period. IOP of <6 mm Hg is used to define hypotonia. Results: There was no statistically significant difference among the patients who underwent PGI and AGV surgeries in terms of IOP averages, both preoperatively and postoperatively on day 1, week 1, month 1, month 3, month 6, and month 12 (P > 0.05). Before PGI and AGV implantation, the mean IOP was 40 ± 13 mm Hg and 39.3 ± 10 mm Hg, and the mean number of medications was 3.8 ± 0.4 and 4 ± 0, respectively. At the end of the 12-month follow-up period, the mean IOP was 13.5 ± 2.2 (P < 0.001) mm Hg and 14.9 ± 4.2 (P < 0.001) mm Hg, whereas the mean number of glaucoma medications decreased to 1.7 ± 1.3 (P < 0.001) and 1.9 ± 1.8 (P < 0.001) in the PGI and AGV groups, respectively. Surgical success was achieved in 17 of 18 eyes (94%) in the PGI group and 16 of 18 eyes (89%) in the AGV group. Conclusions: Although the outcomes were similar in both the PGI and AGV groups, complications requiring medical and surgical intervention were less common in the PGI group. Longer-term studies with a larger sample size are needed to demonstrate the superiority or equivalence of these procedures.