Early Experience with the Paul Glaucoma Implant in Childhood Glaucoma: A Case Series

Abstract

Purpose

The Paul glaucoma implant (PGI, Advanced Ophthalmic Innovations, Singapore, Republic of Singapore) is a recently developed novel non-valved glaucoma drainage device (GDD) designed to effectively reduce the intraocular pressure (IOP) in glaucoma patients with a theoretically reduced risk of postoperative complications such as hypotony, endothelial cell loss, strabismus, and diplopia. Limited literature has evaluated its use in adult glaucoma; however, its use in pediatric glaucoma has not been reported to date. We present our early experience with PGI in refractory childhood glaucoma.

Patients and Methods

This study was retrospective single-surgeon case series in a single tertiary center.

Results

Three eyes of 3 patients with childhood glaucoma were enrolled in the study. During nine months of follow-up, postoperative IOP and number of glaucoma medications were significantly lower than preoperative values in all the enrolled patients. None of the patients developed postoperative complications including postoperative hypotony, choroidal detachment, endophthalmitis, or corneal decompensation.

Conclusion

PGI is an efficient and relatively safe surgical treatment option in patients with refractory childhood glaucoma. Further studies with larger number of participants and longer follow-up period are required to confirm our encouraging results.

Keywords:

• glaucoma
• pediatric
• intraocular pressure
• tube
• Paul glaucoma implant

Abbreviations

AGV, Ahmed glaucoma valve; BCVA, best-corrected visual acuity; BGI, Baerveldt glaucoma implant; C/D, cup-to-disc; ECD, endothelial cell density; GDD, glaucoma drainage devices; IOP, intraocular pressure; LE, left eye; PGI, Paul glaucoma implant; RE, right eye.

Data Sharing Statement

The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Ethics Approval and Informed Consent

Due to the case series nature of our study, it was exempted from ethical approval by the ethical committee of Moorfields Eye Hospital Dubai. Written informed consent was obtained from all subjects and their legal guardians to publish the case details and any accompanying images.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosures

The authors report no relevant financial disclosures.