Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 May 13;15(1):16646.
doi: 10.1038/s41598-025-00839-0.

Efficacy and safety outcomes of the Paul glaucoma implant compared to the Ahmed glaucoma valve

Angi Lizbeth Mendoza-Moreira  1 , Julia V Stingl  2 , Anna Maria Voigt  2 , Jasmin Rezapour  2 , Achim Fiess  2 , Felix Mathias Wagner  2 , Alexander K Schuster  2 , Esther M Hoffmann  3
Affiliations
Comparative Study

Efficacy and safety outcomes of the Paul glaucoma implant compared to the Ahmed glaucoma valve

Angi Lizbeth Mendoza-Moreira et al. Sci Rep. .

Abstract

This study compares the one-year outcomes of standalone Ahmed glaucoma valve (AGV) implantation and standalone Paul glaucoma implant (PGI) in adult patients with primary and secondary glaucoma. A retrospective, single-center, comparative study was conducted on adult patients who underwent standalone PGI and AGV at the University Medical Center Mainz. The primary outcome measures were the changes of IOP and the number of antiglaucoma eye medication at one year postoperatively. Secondary outcome measures included complete and qualified success rates, failure rates, visual acuity logMAR and the incidence of adverse events. A total of 24 adult patients were included in the AGV group and 28 in the PGI group. The median preoperative intraocular pressure decreased from 29.5mmHg (Interquartile range (IQR) 21-42) to 16.0mmHg (IQR 7-37) in the AGV group, and from 34.0 mmHg (IQR 13-56) to 16.0 (IQR 7-21) mmHg in the PGI group at the one-year follow-up. The median number of classes of intraocular pressure-lowering medications reduced from 3.5 to 0 in the AGV group, and from 3.0 to 0 in the PGI group. There were no statistically significant differences between the groups for any success criteria or failure. The AGV produced more encapsulation than the PGI, and the latter more tube exposures. Both the Ahmed Glaucoma Valve and the Paul Glaucoma Implant effectively reduce IOP and the number of antiglaucoma medications at one year with comparable safety profiles.

Keywords: Ahmed glaucoma valve; Drainage; Glaucoma; Paul glaucoma implant; Tube.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: EMH has received research support and consultation fees from Thea, Heidelberg Engineering, Santen, Ora, Allergan, Meyetech, and Belkin Laser. Additionally, Professor Hoffmann has served on advisory boards for these companies.AKS received research support by Bayer, Heidelberg Engineering, Novartis and Santen, and acted as consultant for Abbvie and Santen.JR served as a consultant for Heidelberg Engineering and SantenAll the remaining authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Median IOP values (horizontal black line) and percentiles (boxes-quartiles = 25/75; whiskers = 5/95) given preoperatively and for a follow-up of 1 year. Single outliers are shown by circles and extreme outliers by asterisks.
Fig. 2
Fig. 2
Median number of glaucoma medications (horizontal black line) and percentiles (boxes-quartiles = 25/75; whiskers = 5/95) given preoperatively and for a follow-up of 1 year. Single outliers are shown by circles and extreme outliers by asterisks.
Fig. 3
Fig. 3
Kaplan-Meier survival curves over 1-year postoperatively for complete success at ≤ 21 mmHg with a reduction of > 25%.
Fig. 4
Fig. 4
Kaplan-Meier survival curves over 1-year postoperatively for qualified success at ≤ 21 mmHg with a reduction of > 25%.
Fig. 5
Fig. 5
Kaplan-Meier survival curves over 1-year postoperatively for complete success at ≤ 18 mmHg with a reduction of > 30%.
Fig. 6
Fig. 6
Kaplan-Meier survival curves over 1-year postoperatively for qualified success at ≤ 18 mmHg with a reduction of > 30%.
Fig. 7
Fig. 7
Kaplan-Meier survival curves over 1-year postoperatively for complete success at ≤ 15 mmHg with a reduction of > 40%.
Fig. 8
Fig. 8
Kaplan-Meier survival curves over 1-year postoperatively for qualified success at ≤ 15 mmHg with a reduction of > 40%.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Wishart, P. K., Choudhary, A. & Wong, D. Ahmed glaucoma valves in refractory glaucoma: a 7-year audit. Br. J. Ophthalmol.94, 1174–1179. 10.1136/bjo.2009.165357 (2010). - PubMed
    1. Khodeiry, M. & Sayed, M. S. New glaucoma drainage implants available to glaucoma surgeons. Curr. Opin. Ophthalmol.34, 176–180 (2023). - PubMed
    1. Riva, I. et al. Ahmed glaucoma valve implant: surgical technique and complications. Clin. Ophthalmol. Volume. 11, 357–367. 10.2147/OPTH.S104220 (2017). - PMC - PubMed
    1. Qin, Q. et al. Development and material characteristics of glaucoma surgical implants. Adv. Ophthalmol. Pract. Res.3, 171–179 (2023). - PMC - PubMed
    1. Gedde, S. J., Vinod, K. & Prum, B. E. Results from the primary tube versus trabeculectomy study and translation to clinical practice. Curr. Opin. Ophthalmol.34, 129–137. 10.1097/ICU.0000000000000928 (2023). - PMC - PubMed

Publication types

LinkOut - more resources