Purpose <p>This study evaluated and compared the 1-year outcomes of the PAUL Glaucoma Implant (PGI) and the Ahmed Glaucoma Valve (AGV) in the management of aphakic glaucoma.</p> Methods <p>A retrospective study was conducted on 30 eyes of 28 patients with aphakic glaucoma who underwent implantation of PGI (<i>n</i> = 10) or AGV (<i>n</i> = 20). Primary outcomes included surgical failure and success (complete or qualified). Secondary outcomes included intraocular pressure (IOP) reduction, best-corrected visual acuity (BCVA), medication use, and postoperative complications. Kaplan–Meier survival analysis was applied, with failure defined as IOP &gt; 21 mmHg on two consecutive visits, implant removal, additional glaucoma surgery, or vision loss.</p> Results <p>At 12 months, surgical success was achieved in 90% of PGI eyes and 75% of AGV eyes (<i>p</i> = 0.766). Complete success occurred in 30% (PGI) and 25% (AGV), while failure occurred in one PGI eye and five AGV eyes. Kaplan–Meier analysis revealed comparable cumulative success rates (<i>p</i> = 0.475). Mean IOP at 12 months was similar between groups (16.0 vs. 16.4 mmHg; <i>p</i> = 0.854), with significant reductions from baseline (PGI: <i>p</i> = 0.002; AGV: <i>p</i> &lt; 0.001). Both groups showed reduced medication burden (<i>p</i> &lt; 0.001), with PGI requiring fewer agents at 1–2 months (<i>p</i> = 0.024). BCVA remained stable. One complication was recorded, a case of choroidal haemorrhage in the AGV group; the hypotony episode was not classified as a complication as it resolved without visual loss or further surgical intervention.).</p> Conclusions <p>PGI and AGV both effectively managed aphakic glaucoma. PGI demonstrated a trend toward higher success rates and fewer complications; however, these differences were not statistically significant. These findings suggest that PGI may be a favourable alternative, although larger prospective studies are needed to confirm this potential advantage.</p>