Abstract
OBJECTIVE: A systematic review and meta-analysis evaluating the peer-reviewed literature describing the efficacy of the Paul glaucoma implant (PGI) in managing intraocular pressure (IOP) and its outcomes. METHODS: Comprehensive searches were conducted across major databases to identify relevant studies. The analysis focused on glaucoma patients who underwent PGI. The primary outcomes included failure rate, success rates (complete and qualified), reduction in IOP and post-operative complications. Reduction in medication use was assessed as secondary outcome. A random-effects model was applied for the meta-analysis, and pooled estimates were calculated using Comprehensive Meta-Analysis software. RESULTS: Out of the 255 articles screened, six studies met the eligibility criteria with a total sample of 267 eyes. In glaucoma patients receiving the PGI, complete (56.4%) and qualified success rates were 56.4 and 80.3% respectively. The mean reduction in IOP was 13.62 mmHg, demonstrating a significant difference vs baseline (p < 0.0001). Furthermore, there was a significant reduction in medications by 2.80 (p < 0.0001).The average rate of hypotony (all definitions) was 5.12%. CONCLUSION: This meta-analysis provides evidence supporting the efficacy of PGI in controlling intraocular pressure and achieving good outcomes for glaucoma patients.