Glaucoma drainage devices - Is the Paul glaucoma implant suitable for children with glaucoma?
May 21, 2025

Glaucoma drainage devices - Is the Paul glaucoma implant suitable for children with glaucoma?

Only a few studies exist on the Paul glaucoma device in children with glaucoma. Compared to Ahmed glaucoma Valve or Baerveldt implant, there is little evidence on the new glaucoma drainage implant in children. Some small studies (1, 2) describe good IOP reduction in congenital and aphakic glaucoma children but numbers in these studies are low.
However, altough literature is rare on Paul Glaucoma implant in children yet, there is some evidence that this method can be recommended for some childhood glaucoma cases. This has been proven by a recent randomized clinical trial including young children and adolescents ≤ 18 years with childhood glaucoma (3) comparing Paul glaucoma implant (PGI) to an Ahmed Glaucoma Valve (AGV). Paul Glaucoma implant showed slightly higher success rates compared to Ahmed Valve implant. While current evidence on the efficacy of the Paul implant in children remains limited, early clinical experience is promising. As more pediatric -focused studies are underway, the Paul glaucoma implant may emerge as a valuable option, especially in cases where traditional glaucoma drainage devices present challenges.


References

  1. Vallabh NA, Mohindra R, Drysdale E, Mason F, Fenerty CH, Yau K. The PAUL® glaucoma implant: 1-year results of a novel glaucoma drainage device in a paediatric cohort. Graefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2351-2358.
  2. Mendoza-Moreira AL, Voigt AM, Stingl JV, Rezapour J, Wagner FM, Schuster AK,Hoffmann EM. Paul Glaucoma Implant following Congenital Cataract Surgery in aPediatric Cohort. J Clin Med. 2024 May 15;13(10):2914.
  3. Elhusseiny AM, Khaled OM, Chauhan MZ, Sayed MS, Shaarawy T. Initial Results of the Paul Ahmed Comparison (PAC) Study in Refractory Childhood Glaucoma. Am J Ophthalmol. 2025 Mar:271:71-78


Contributor: Esther Hoffmann, Eye Clinic, Unversity of Mainz

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