Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes Under Different Levels of Glaucoma Severity: A Multicenter, Comparative Study

To evaluate the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) under different levels of glaucoma severity. Retrospective, multicenter, before-and-after study. One eye from all primary open-angle glaucoma patients who underwent GATT combined with cataract surgery (Phaco-GATT) or G...

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Published in:	American journal of ophthalmology Vol. 264; pp. 75 - 84
Main Authors:	Magacho, Leopoldo, Franco, Cláudia Gomide Vilela de S., I, Eduardo Akio, Pereira, Ana Cláudia Alves, Teno, Bruno, Lucena-Neto, Francisco, Faria, Bruno M., Vieira, Júlia Maggi, Vianello, Marcos Pereira, Kanadani, Fábio N.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-08-2024
Subjects:	Aged Aged, 80 and over Antihypertensive Agents - therapeutic use Female Follow-Up Studies Glaucoma, Open-Angle - physiopathology Glaucoma, Open-Angle - surgery Gonioscopy Humans Intraocular Pressure - physiology Lens Implantation, Intraocular Male Middle Aged Phacoemulsification - methods Retrospective Studies Severity of Illness Index Tonometry, Ocular Trabeculectomy - methods Treatment Outcome Visual Acuity - physiology
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Summary:	To evaluate the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) under different levels of glaucoma severity. Retrospective, multicenter, before-and-after study. One eye from all primary open-angle glaucoma patients who underwent GATT combined with cataract surgery (Phaco-GATT) or GATT stand-alone with 12 months of follow-up were included and divided according to glaucoma severity (mild = GI, moderate = GII, and advanced = GIII) and the outcomes compared. A total of 270 eyes were included: 90 in GI, 75 in GII, and 105 in GIII. The IOP was reduced from 18.6 ± 6.0 mm Hg in GI, 19.7 ± 6.4 mm Hg in GII, and 21.0 ± 7.9 mm Hg in GIII, preoperatively, to 11.9 ± 2.6 mm Hg in GI, 11.8 ± 2.1 mm Hg in GII, and 11.9 ± 3.0 mm Hg in GIII at 12 months postoperatively (P < .001 for all). The number of hypotensive ocular medications were reduced from 2.7 ± 1.0 in GI, 3.1 ± 0.8 in GII, and 3.2 ± 1.2 in GIII to 0.6 ± 0.9 in GI, 1.0 ± 1.1 in GII, and 1.2 ± 1.1 in GIII at the last postoperative visit (P < .001 for all). Relative success was achieved, at 1 year, in 93.8% of the eyes in GI, 89.0% in GII, and 88.1% in GIII (P = .3). Complete success was achieved in 61.8% of the eyes in GI, 43.8% in GII, and 37.6% in GIII (P = .007). No serious adverse event was observed in any group. GATT is a safe and effective procedure in glaucoma, regardless of its preoperative severity.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9394 1879-1891 1879-1891
DOI:	10.1016/j.ajo.2024.02.033