Abstract
OBJECTIVES: To compare the outcomes of Paul (PGI) and Ahmed glaucoma implants (AGI) in patients with complex glaucoma. METHODS: 64 patients undergoing PGI and 40 patients undergoing AGI were included in this study. Intraocular pressure (IOP), the number of IOP-lowering eye drops, and complications were evaluated during an 18-month follow-up. RESULTS: At 18 months, follow-up was completed by 26 patients (65.0%) in the AGI group and 45 patients (70.3%) in the PGI group. IOP was significantly reduced 18 months following PGI (12.3 ± 4.0 vs. 28.0 ± 9.3 mmHg, p < 0.001) and AGI (15.6 ± 5.2 vs. 30.7 ± 8.9 mmHg, p < 0.001) compared to preoperatively. The PGI achieved significantly lower IOP compared to the AGI group (p = 0.042). Similarly, the use of IOP-lowering eye drops decreased significantly at 18 months in the PGI (0.5 ± 0.8, p < 0.001) and AGI (1.3 ± 1.0, p < 0.001) groups, from baseline values of 3.3 ± 1.3 in PGI and 3.5 ± 1.3 in AGI. The number of IOP-lowering eye drops was significantly lower in the PGI than in the AGI group at both 12 (p = 0.031) and 18 months (p = 0.018). At the 18-month follow-up, qualified success rates for target pressures ≤18 mmHg were higher after PGI than AGI (IOP ≤ 18 mmHg: 66.6% vs. 84.2%, p = 0.017, ≤ 15 mmHg: 46.3% vs. 64.8%, p = 0.049, ≤ 12 mmHg: 24.9% vs. 43.0%, p = 0.047). There was no significant difference in the complication rates between PGI and AGI. CONCLUSION: Both PGI and AGI effectively reduced IOP and the number of IOP-lowering eye drops over an 18-month follow-up period. The PGI demonstrated significantly greater reductions in IOP and IOP-lowering eye drops than AGI at 18 months. The safety profiles of PGI and AGI were comparable.