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Table 1.

Patient characteristics in the Ahmed® glaucoma implant (AGI) and Paul® glaucoma implant (PGI) groups. POAG: primary open angle glaucoma, PSXG: pseudoexfoliative glaucoma.

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Table 2.

Number and percentages of prior ocular surgeries in the Ahmed® glaucoma implant (AGI) and Paul® glaucoma implant (PGI) group. SLT: selective laser trabeculoplasty, Kahook®: Kahook Dual Blade (New World Medical, Rancho Cucamonga, CA, USA), XEN®: XEN gel stent (Allergan Inc., CA, USA), iStent®: iStent trabecular micro-bypass stent (Glaukos Corporation, Laguna Hills, CA, USA).

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Fig 1.

The base plate of a Paul® glaucoma implant is placed in the supero-temporal quadrant beneath the recti muscles.

A 6−0 non-absorbable monofilament polypropylene suture (Prolene, Ethicon, Johnson & Johnson Medical GmbH, Norderstedt, Germany) is partly inserted into the tube to reduce immediate aqueous humour flow and to prevent early postoperative hypotony (a). The tip of the tube is guided through a deep scleral tunnel into the anterior chamber (b). The part of the tube that lies on the sclera is covered with a corneal donor patch (c). The conjunctiva is closed using Vicryl 8−0 (Ethicon) (d).

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Fig 2.

Mean intraocular pressure (IOP, a) and the mean number of IOP-lowering eye drops (b) preoperatively (preop) and at 1 day, 1 week, 6 weeks, and 3, 6, 12, and 18 months after Ahmed® glaucoma implant (AGI) and PAUL® glaucoma implant (PGI).

Compared to preop, IOP was significantly (*) reduced at all follow-ups in both the AGI and PGI group (p < 0.001). At the 18-month follow-up, IOP was significantly lower following PGI than AGI (p = 0.042). Similarly, the number of IOP-lowering eye drops was significantly lower in the PGI compared to the AGI group at the 12- (p = 0.031) and 18-month follow-up (p = 0.018).

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Fig 2 Expand

Fig 3.

Kaplan-Meier curves for the Ahmed® (AGI, orange) and PAUL® glaucoma implant (PGI, blue) groups.

Complete and qualified success rates for intraocular pressure ≤ 21, 18, 15, and 12 mmHg.

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Fig 3 Expand

Table 3.

Postoperative complications between Ahmed® glaucoma implant (AGI) and Paul® glaucoma implant (PGI) surgery.

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