Predictive factors for the success of the Paul glaucoma implant: a one-year multicenter prospective study

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.

Authors

Institutions

Publication Details

Journal
Scientific Reports
Published
2025-11-03
DOI
https://doi.org/10.1038/s41598-025-18369-0
Primary Topic
Glaucoma and retinal disorders
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Predictive factors for the success of the Paul glaucoma implant: a one-year multicenter prospective study

J.M. Martínez-de-la-Casa, Elena Arrondo, Miguel Naveiras, María J. Chaves-Samaniego et al.
Scientific Reports
Glaucoma and retinal disorders
article

Predictive factors for the success of the Paul glaucoma implant: a one-year multicenter prospective study

J.M. Martínez-de-la-Casa, Elena Arrondo, Miguel Naveiras, María J. Chaves-Samaniego, Jesús Téllez, S. Perucho Martínez, R. Cansino Hurtado, Javier Moreno-Montañés, Susana Duch, Miriam de la Puente, Aitor Lanzagorta-Aresti, Elena Millá, Cristina Irigoyen, J.L. Bóveda, J. Vila, Carlos Arciniegas, Lucía Rial Álvarez, José I. Belda, J. Quera, M. Vázquez Rodríguez, Alfonso Antón, Marta Castany, Lucía Perucho, Francesc Franquesa-Garcia, Manuel Bueno Sánchez, Jordi Loscos, Natalia Olmo, Elena Ávila, Mercè Perramon, Angelica de Freytas, Emma Ausín, Teresa Colas, Noelia Druetta, Daniel Gómez Plaza, Julia Barreiro Honrado, José Vicente Piá
article en

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.

Scientific ReportsVol. 15(1)
Universitat de València (ES), Hospital de Sant Pau (ES), Generalitat Valenciana (ES), Hospital Clínico San Carlos (ES), Hospital Universitari i Politècnic La Fe (ES), Universitat Internacional de Catalunya (ES), Innovatec (Spain) (ES), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (ES), Hospital Clínic de Barcelona (ES), Complejo Hospitalario de Jaén (ES), Miranza (ES), Hospital de Manises (ES), Vall d'Hebron Hospital Universitari (ES), Instituto de Microcirugía Ocular (ES), Clinica Universidad de Navarra (ES), Hospital Quirón Torrevieja (ES), Hospital Universitario de Fuenlabrada (ES), Hospital Universitario Son Espases (ES), Hospital Universitari Germans Trias i Pujol (ES), Complejo Hospitalario de Pontevedra (ES), Hospital Universitario Infanta Leonor (ES), Universitat de Barcelona (ES)
Openalex Percentile: Top 54%
Glaucoma and retinal disorders
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.