This single German centre retrospective cohort study included 70 eyes from 68 patients. Qualified and complete success rates (95% CI) were 92.9% and 55.7% after 1 year and 88.6% (81.4–95.7%) and 50% (37.1–62.9%) at the last follow-up time point for intraocular pressure (IOP) ≤18mmHg, and 81.4% and 54.3% and 70% and 42.9% IOP ≤15mmHg, respectively. Mean IOP decreased from 23.93–12.07mmHg after 12 months, 11.32mmHg after 24 months, and 10.41mmHg after 36 months. The mean number of IOP-lowering eye drops was 0 before and immediately after removal and increased to 1.57 (0–2) at 12 months, 1.15 (0–4) at 24 months, and 1.12 (0–4) at 36 months. Postoperative complications occurred in 5 eyes (7.1%). Two eyes had suprachoroidal hemorrhage, with 1 needing vitrectomy and 1 external tube ligation; 1 required Paul® glaucoma implant (PGI) explantation for persistent hypotony with early removal of the PROLENETM suture (2 cases removal took place between 6–8 weeks post-op due to advanced glaucoma). The authors concluded that removal of the PROLENE™ stent following PGI surgery effectively lowers IOP in the short term, with a moderate increase in IOP and need for pressure-lowering therapy over time. However, it should be noted that for patients undergoing early removal (<8 weeks) and with systemic risk factors, adverse outcomes such as hypotony and suprachoroidal hemorrhage, may occur. Eye surgeons can be reassured of the outcomes of this study, however should adapt their approach to each individual case.
Clinical outcomes following intraluminal stent removal from the PAUL glaucoma implant
Reviewed by Su Young
Clinical outcomes of intraluminal stent removal after PAUL glaucoma implant surgery.
CONTRIBUTOR
Su Young
Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, UK.
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