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The PAUL\u00ae Glaucoma Implant (PGI), with its refined, smaller drainage tube, presents a promising solution for lowering intraocular pressure (IOP) in such complex cases.<\/jats:p>\n                    <jats:p>This study aims to evaluate the PGI\u2019s effectiveness and safety in managing IOP in patients with NVG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study reviewed medical records of patients who underwent PGI surgery for NVG at the University Hospital Bonn between May 2021 and January 2024. Preoperative and follow-up data, including IOP, BCVA, visual field progression, and complications, were collected prospectively. Success was defined using four IOP-based criteria (\u2264\u200921,\u2009\u2264\u200918,\u2009\u2264\u200915, and\u2009\u2264\u200912\u00a0mmHg) per World Glaucoma Association (WGA) guidelines (World Glaucoma Association et al. 2009). Outcomes were classified as complete (without medication) or qualified (with or without medication). Failure included hypotony-related complications, need for further surgery, or PGI explantation. The primary endpoint was success rate by IOP criteria; secondary endpoints included changes in IOP, BCVA, medication use, complications, and impact of Prolene stent removal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study analyzed 23 eyes from 22 patients undergoing PGI surgery, with the majority being male (60.9%) and Caucasian (95.7%), and with an average age of 65.2\u00a0years. Success rates were highest for IOP\u2009\u2264\u200921\u00a0mmHg (60%\u201380% at 12\u00a0months) and declined with stricter thresholds, with only 10% maintaining IOP\u2009\u2264\u200912\u00a0mmHg. Prior to surgery, the mean intraocular pressure (IOP) was 27.22\u00a0mmHg. Following the procedure, a substantial reduction was observed, with IOP decreasing to 12.95\u00a0mmHg at the 12-month follow-up\u2014representing an average decrease of 53.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PGI demonstrates significant IOP reduction in NVG, with sustained success at higher IOP thresholds. However, maintaining very low IOP levels remains challenging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-025-06933-3","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:38:24Z","timestamp":1756294704000},"page":"3199-3209","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of the PAUL Glaucoma implant for neovascular glaucoma"],"prefix":"10.1007","volume":"263","author":[{"given":"Carolin","family":"Deubel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Walz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Petrak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank G.","family":"Holz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffael","family":"Liegl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Mercieca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9714-2851","authenticated-orcid":false,"given":"Constance","family":"Liegl n\u00e9e Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"6933_CR1","unstructured":"World Glaucoma Association, Shaarawy TM, Sherwood M, Grehn F (2009) Guidelines on design and reporting of glaucoma surgical trials. 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Due to the retrospective character of this study and since used data does not allow to identify patients, a waiver of informed consent was obtained by the local ethics committee. The ethics review board at the University of Bonn, \u201cEthikkommission der Universit\u00e4t Bonn\u201d gave a waiver under the reference number 258\/21. The research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent statement"}},{"value":"CD, WW, MP, RL and CL certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers\u2019 bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.KM has received honoraria or research grants from the following: Allergan\/Abbvie (C,H,R) and Glaukos (C,H,R), but none of this is related to the current study.FGH has received honoraria or research grants from the following: Acucela (C,F), Allergan (F), Apellis (C, F), Bayer (C, F), Boehringer-Ingelheim (C), Bioeq\/Formycon (F,C), CenterVue (F), Ellex (F), Roche\/Genentech (C,F), Geuder (C,F), Graybug (C), Gyroscope (C), Heidelberg Engineering (C,F), IvericBio (C, F), Kanghong (C,F), LinBioscience (C), NightStarX (F), Novartis (C,F), Optos (F), Oxurion (C), Pixium Vision (C,F), Oxurion (C), Stealth BioTherapeutics (C), Zeiss (F,C), but none of this is related to the current study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}