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Journal of Glaucoma· 2026Q1

Outcomes of the Paul Glaucoma Implant for Refractory Glaucoma in an Indonesian Population

Emma Rusmayani, Iwan Soebijantoro, Arini Safira Nurul Akbar, Muhammad Yoserizal et al.

Short summary

The Paul Glaucoma Implant successfully reduced intraocular pressure (IOP) by 57% (from 35 to 15 mmHg) and medication use by 67% in Indonesian patients with refractory glaucoma over two years, with a low 4.96% rate of self-resolving hypotony.

AI-generated from the title and abstract; the full text is not read.

Key points

  • Median intraocular pressure decreased from 35 mmHg preoperatively to 15 mmHg at one and two years post-implantation.
  • Glaucoma medication use decreased from a median of 3 to 1 daily.
  • The overall success rate of the Paul Glaucoma Implant was 98.08% at one year and 92.68% at two years.
  • Postoperative hypotony occurred in 4.96% of cases and was self-resolving.
  • An intraluminal 6/0 prolene stent was used in implantations and removed in 66.94% of cases.

AI-generated from the title and abstract; the full text is not read.

Abstract

PRECIS: The Paul Glaucoma Implant demonstrated favorable short- to mid-term outcomes in patients with refractory glaucoma in the Indonesian population. Low rates of postoperative hypotony following implantation were observed with the use of intraluminal 6/0 prolene stent. PURPOSE: To evaluate the efficacy and safety of the Paul Glaucoma Implant in managing refractory glaucoma in the Indonesian population. PATIENTS AND METHODS: This retrospective study reviewed patients who underwent implantation of the Paul Glaucoma Implant at the Kedoya and Menteng branches of the Jakarta Eye Center between September 2022 and January 2025. RESULTS: 121 implantations from 113 patients were included, with a median follow-up of 12.00 (12.00 - 24.00) months. Median intraocular pressure decreased from 35.00 (28.25 - 43.00) mmHg preoperatively to 15.00 (11.00 - 18.00) mmHg at one year and 15.00 (12.00 - 18.00) mmHg at two years. Median glaucoma medication use decreased from 3.00 (3.00 - 4.00) to 1.00 (0.00 - 1.00). Median best-corrected visual acuity improved from 0.30 (0.02 - 1.47) logarithm of the minimum angle of resolution preoperatively to 0.15 (0.00 - 1.00) at one year and 0.10 (0.00 - 0.60) at two years. Overall success rate of the Paul Glaucoma Implant was 98.08% at one year and 92.68% at two years. Four implantations (3.30%) failed, including two requiring explantation and two failing to achieve the target intraocular pressure reduction. Hypotony occurred in six eyes (4.96%), all self-resolving. An intraluminal 6/0 prolene stent was employed for implantations and removed in 81 eyes (66.94%), with a median removal time of 3.00 (2.00 - 4.00) weeks. CONCLUSION: The Paul Glaucoma Implant demonstrated favorable short- to mid-term outcomes, with substantial reductions in intraocular pressure and glaucoma medication use and a low rate of postoperative hypotony.

The authors' abstract, as published at the source. Journal of Glaucoma, 2026 · DOI ↗

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Field: Ophthalmology

OphthalmologyMedicine