This systematic review and single-arm meta-analysis evaluated the effect of intraluminal stent removal from the Paul Glaucoma Implant (PGI) on IOP reduction, long-term efficacy, and safety across 5 observational studies (283 eyes).
Stent removal produced a significant pooled IOP reduction of **−9.09 mmHg** (95% CI: −11.77 to −6.41). Patients with pre-removal IOP >21 mmHg had a larger drop (−11.82 mmHg) vs. those with IOP <21 mmHg (−6.66 mmHg). Clinically significant hypotony was rare at a pooled proportion of 0.03 (95% CI: 0.00–0.15; I²=0%).
- Only 5 observational studies were included, all carrying inherent bias risk assessed via ROBINS-I. - No randomized controlled trial data available for comparison. - Long-term efficacy data beyond immediate post-removal period are limited.
Consider intraluminal stent removal as a safe, effective next step for PGI patients with persistently elevated IOP (>21 mmHg), where the IOP-lowering effect is most pronounced. The low hypotony risk supports its use without major safety concerns.
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