Evidence map›Paper›PMID 42597599›Full record

ArticleAmerican journal of ophthalmology case reports2026

Recurrent aqueous misdirection following intraluminal ripcord removal from a Paul Glaucoma Implant.

Silvio Semeria, Valentina Romani, Alessandro Siligato, Matteo Cacciatori, Giovanni Milano, Giacinto Triolo

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Silvio SemeriaDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Camillo Golgi, 19, Pavia, 27100, Italy.
Valentina RomaniDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Camillo Golgi, 19, Pavia, 27100, Italy.
Alessandro SiligatoEye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Via Giovanni Battista Grassi, 74, Milano, 20157, Italy.
Matteo CacciatoriEye Clinic, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, 19, Pavia, 27100, Italy.
Giovanni MilanoDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Camillo Golgi, 19, Pavia, 27100, Italy.
Giacinto TrioloDepartment of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Camillo Golgi, 19, Pavia, 27100, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To report a case of aqueous misdirection occurring shortly after intraluminal ripcord removal in a pseudophakic, previously vitrectomized eye implanted with a PAUL Glaucoma Implant. Case description: A 65-year-old Caucasian woman presented with primary angle-closure glaucoma and previous history of aqueous misdirection following a combined procedure of phacoemulsification and XEN45 gel stent implant, which was managed with pars plana vitrectomy elsewhere. Because of high IOP despite maximum tolerated medical treatment, a PAUL Glaucoma Implant was performed with positioning of a 6-0 Prolene® intraluminal ripcord. Shortly after ripcord removal 6 weeks postoperatively, she presented with significant myopic shift, uniformly shallow anterior chamber, and markedly raised IOP. Anterior-segment OCT showed patent tube in the superotemporal quadrant of the anterior chamber, suggesting the recurrence of aqueous misdirection. Revision of pars plana vitrectomy with extensive peripheral vitreous shaving and irido-zonulo-hyaloidectomy was required to restore anterior chamber depth, to re-establish forward aqueous flow, and to stabilize IOP. Conclusions and importance: This case suggests that intraluminal ripcord removal from a PAUL glaucoma implant can elicit aqueous misdirection in eyes at risk. Furthermore, the final outcomes of the present case suggest that thorough pars plana vitrectomy with irido-zonulo-hyaloidectomy may be the most effective surgical approach to aqueous misdirection.

Indexed as

Aqueous misdirectionMalignant glaucomaPaul glaucoma ImplantPrimary angle-closure glaucomaRipcord removal

Identifiers

PMID42597599
PMCPMC13470117

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.