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The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort

PURPOSE: The PAUL® glaucoma implant (PGI) is a novel glaucoma drainage device, which has not been previously reported in paediatric glaucoma management. This study aims to evaluate the safety and effectiveness of the PGI in a paediatric cohort. METHODS: A retrospective evaluation of 25 cases of paed...

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Autores principales: Vallabh, Neeru Amrita, Mohindra, Ravi, Drysdale, Elizabeth, Mason, Fiona, Fenerty, Cecilia H., Yau, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028749/
https://www.ncbi.nlm.nih.gov/pubmed/36943459
http://dx.doi.org/10.1007/s00417-023-06000-9
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author Vallabh, Neeru Amrita
Mohindra, Ravi
Drysdale, Elizabeth
Mason, Fiona
Fenerty, Cecilia H.
Yau, Kenneth
author_facet Vallabh, Neeru Amrita
Mohindra, Ravi
Drysdale, Elizabeth
Mason, Fiona
Fenerty, Cecilia H.
Yau, Kenneth
author_sort Vallabh, Neeru Amrita
collection PubMed
description PURPOSE: The PAUL® glaucoma implant (PGI) is a novel glaucoma drainage device, which has not been previously reported in paediatric glaucoma management. This study aims to evaluate the safety and effectiveness of the PGI in a paediatric cohort. METHODS: A retrospective evaluation of 25 cases of paediatric PGI surgery (age 8 months to 16 years) was performed at Manchester Royal Eye Hospital between September 2019 and July 2020. Primary outcome measures included failure (intraocular pressure (IOP) > 21 mmHg or < 20% reduction of IOP, removal of the implant, further glaucoma intervention or visual loss. Secondary outcomes included mean IOP, mean number of medications, logMAR visual acuity and complications. RESULTS: Eleven eyes (48%) had a complete success and achieved an unmedicated IOP < 21 mmHg, and 21 eyes (84%) had a qualified success (with or without medications). Four failures were observed, 2 due to hypotony and 2 underwent further surgery (gonioscopy-assisted transluminal trabeculotomy). The mean preop IOP was 30.9 ± 5.9 mmHg (n = 25), falling to 13.5 ± 6.8 mmHg at 1 month, 17.9 ± 7.2 mmHg at 3 months, 13.4 ± 5.1 mmHg at 6 months, 13.2 ± 4.9 mmHg at 12 months and 11.8 ± 4.6 mmHg at 24 months. The mean change in IOP from the preoperative visit to the last visit was a reduction of 19.1 ± 7.7 mmHg. A significant reduction in the number of medications and IOP was demonstrated after PGI (p < 0.0001). Nine patients required removal of the intraluminal Prolene stent from the PGI for further pressure lowering. CONCLUSION: The one- to two-year results demonstrate paediatric PGI has high qualified success rates and effectively reduces IOP and the need for glaucoma medical therapy. [Image: see text]
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spelling pubmed-100287492023-03-21 The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort Vallabh, Neeru Amrita Mohindra, Ravi Drysdale, Elizabeth Mason, Fiona Fenerty, Cecilia H. Yau, Kenneth Graefes Arch Clin Exp Ophthalmol Glaucoma PURPOSE: The PAUL® glaucoma implant (PGI) is a novel glaucoma drainage device, which has not been previously reported in paediatric glaucoma management. This study aims to evaluate the safety and effectiveness of the PGI in a paediatric cohort. METHODS: A retrospective evaluation of 25 cases of paediatric PGI surgery (age 8 months to 16 years) was performed at Manchester Royal Eye Hospital between September 2019 and July 2020. Primary outcome measures included failure (intraocular pressure (IOP) > 21 mmHg or < 20% reduction of IOP, removal of the implant, further glaucoma intervention or visual loss. Secondary outcomes included mean IOP, mean number of medications, logMAR visual acuity and complications. RESULTS: Eleven eyes (48%) had a complete success and achieved an unmedicated IOP < 21 mmHg, and 21 eyes (84%) had a qualified success (with or without medications). Four failures were observed, 2 due to hypotony and 2 underwent further surgery (gonioscopy-assisted transluminal trabeculotomy). The mean preop IOP was 30.9 ± 5.9 mmHg (n = 25), falling to 13.5 ± 6.8 mmHg at 1 month, 17.9 ± 7.2 mmHg at 3 months, 13.4 ± 5.1 mmHg at 6 months, 13.2 ± 4.9 mmHg at 12 months and 11.8 ± 4.6 mmHg at 24 months. The mean change in IOP from the preoperative visit to the last visit was a reduction of 19.1 ± 7.7 mmHg. A significant reduction in the number of medications and IOP was demonstrated after PGI (p < 0.0001). Nine patients required removal of the intraluminal Prolene stent from the PGI for further pressure lowering. CONCLUSION: The one- to two-year results demonstrate paediatric PGI has high qualified success rates and effectively reduces IOP and the need for glaucoma medical therapy. [Image: see text] Springer Berlin Heidelberg 2023-03-21 /pmc/articles/PMC10028749/ /pubmed/36943459 http://dx.doi.org/10.1007/s00417-023-06000-9 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Glaucoma
Vallabh, Neeru Amrita
Mohindra, Ravi
Drysdale, Elizabeth
Mason, Fiona
Fenerty, Cecilia H.
Yau, Kenneth
The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title_full The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title_fullStr The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title_full_unstemmed The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title_short The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
title_sort paul® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort
topic Glaucoma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028749/
https://www.ncbi.nlm.nih.gov/pubmed/36943459
http://dx.doi.org/10.1007/s00417-023-06000-9
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