Paul Glaucoma Implant Versus Ahmed Glaucoma Valve in Pediatric Glaucoma Following Congenital Cataract Surgery.

PRCIS: Both PGI and AGV can be used to lower intraocular pressure with a good safety profile in children with glaucoma following cataract surgery.

PURPOSE: To compare the effectiveness and safety of the Paul Glaucoma Implant (PGI) and the Ahmed Glaucoma Valve (AGV) in children with glaucoma following congenital cataract surgery (GFCS).

PATIENTS AND

METHODS

This retrospective study included children aged 0-17 years with GFCS who underwent PGI implantation at a tertiary center between 2022 and 2024, with at least 1 year of follow-up. Outcomes were compared with a retrospective cohort treated with AGV. Primary outcomes were a reduction in intraocular pressure (IOP) and the number of antiglaucoma medications. Secondary outcomes included surgical success, defined as IOP ≤21 mm Hg and ≥6 mm Hg without failure criteria. Failure was defined as 2 consecutive IOP measurements outside the target after 3 months, need for oral acetazolamide, reoperation, implant explantation, or loss of light perception. Intraoperative and postoperative complications were recorded.

RESULTS

Fourteen eyes from 12 patients (7 per group) completed 1-year follow-up. Mean IOP decreased significantly in both groups, from 26.7±5.2 to 14.4±3.0 mm Hg in the AGV group and from 30.4±9.7 to 12.6±4.5 mm Hg in the PGI group, with no significant intergroup difference. Median medication use decreased from 3 (IQR: 0) to 0 (IQR: 1) in the AGV group and from 4 (IQR: 1) to 2 (IQR: 2) in the PGI group. Complete or qualified success was achieved in 85.7% of AGV eyes and 100% of PGI eyes. No serious complications occurred.

CONCLUSION

PGI and AGV showed comparable efficacy, safety, and surgical success in children with GFCS.