Comparative outcomes of Ahmed glaucoma valve implant and Paul glaucoma implant in managing aphakic glaucoma: A case report.

INTRODUCTION

Managing intraocular pressure (IOP) in aphakic glaucoma is challenging, as it may often require glaucoma drainage devices (GDDs). While the Ahmed glaucoma valve (AGV) is widely used, the Paul glaucoma implant (PGI) is emerging as a viable alternative with potential advantages in IOP control and fewer complications. This report compares AGV and PGI outcomes in aphakic glaucoma management.

CASE PRESENTATION

A 15-year-old male with congenital cataracts and aphakic glaucoma presented with uncontrolled IOP despite medical therapy. The right eye underwent AGV surgery, while the left underwent PGI surgery. Both devices controlled IOP, though the AGV required repositioning due to tube migration, whereas the PGI resulted in a transient IOP rise before stabilizing.

DISCUSSION

Both the AGV and PGI effectively controlled IOP. The PGI provided more stable visual outcomes. While studies report similar IOP reductions for both devices, the PGI's design may contribute to more predictable visual stabilization. Tube migration, a complication observed with the AGV in this case, has been reported in other studies. The PGI may offer fewer complications and better long-term vision outcomes, making it a promising option for pediatric aphakic glaucoma management.

CONCLUSION

In this pediatric aphakic glaucoma case, the PGI resulted in more stable visual outcomes compared to the AGV. While both implants were effective in IOP control, the PGI may offer better long-term stability with fewer complications. However, further studies involving larger cohorts are required to validate these findings.