Zeynep Aktas1, Ahmet Y Ucgul2, Caglar Bektas1, Selin Sahin Karamert1. 1. Department of Ophthalmology, Gazi University School of Medicine, Ankara. 2. Department of Ophthalmology, Abant Izzet Baysal University, Training and Research Hospital, Bolu, Turkey.
Abstract
PRéCIS:: The present study demonstrates that surgical success rate of gonioscopy-assisted transluminal trabeculotomy (GATT) is 83.7% according to target intraocular pressure (IOP) ≤21 mm Hg and ≥20% reduction from baseline in patients with moderate to advanced glaucoma, with an average follow-up of 19.4 months. PURPOSE: The aim of the study was to assess the outcomes of GATT in eyes with moderate to advanced open-angle glaucoma. PATIENTS AND METHODS: A retrospective study included 104 eyes of 104 patients, with a mean age of 58.9±18.5 (15 to 87) years, who underwent GATT using the 6/0 prolene suture to treat open-angle glaucoma. The GATT procedure was carried out alone or in combination with phacoemulsification. IOP at baseline, third, sixth, ninth, 12th, and 18th months of follow-up; need of antiglaucoma medication; need of further glaucoma surgery; cup/disc ratio; and best-corrected visual acuity (BCVA) were recorded. Patients with prior incisional glaucoma surgery were excluded. Surgical success was determined for both IOP <21 and <18 mm Hg and also ≥20% reduction from baseline without further glaucoma surgery. RESULTS: A total of 65 patients with primary open-angle glaucoma (POAG) and 39 patients with secondary open-angle glaucoma (SOAG), including pseudoexfoliative, pigmentary, uveitic, and steroid-induced glaucoma underwent GATT. Preoperative mean IOP was 25.0±7.3 mm Hg. Preoperative average number of antiglaucoma medications was 3.4±0.6. The average follow-up time was 19.4±8.1 (6 to 37) months. Preoperative average BCVA was 0.51±0.24, and cup/disc ratio was 0.85±0.14. Surgical success was achieved in 87 of 104 (83.7%). Seven patients had medically uncontrolled glaucoma after GATT surgery, and they underwent further surgery. Patients with POAG had a higher percentage of IOP reduction than patients with SOAG at 18th month of follow-up (40.1% vs. 27.6%). Need for medication at final visit was similar between POAG and SOAG. CONCLUSION: GATT procedure is a safe and successful option for the treatment of moderate to advanced open-angle glaucoma. Surgical success could be maintained up to ∼18 months.
PRéCIS:: The present study demonstrates that surgical success rate of gonioscopy-assisted transluminal trabeculotomy (GATT) is 83.7% according to target intraocular pressure (IOP) ≤21 mm Hg and ≥20% reduction from baseline in patients with moderate to advanced glaucoma, with an average follow-up of 19.4 months. PURPOSE: The aim of the study was to assess the outcomes of GATT in eyes with moderate to advanced open-angle glaucoma. PATIENTS AND METHODS: A retrospective study included 104 eyes of 104 patients, with a mean age of 58.9±18.5 (15 to 87) years, who underwent GATT using the 6/0 prolene suture to treat open-angle glaucoma. The GATT procedure was carried out alone or in combination with phacoemulsification. IOP at baseline, third, sixth, ninth, 12th, and 18th months of follow-up; need of antiglaucoma medication; need of further glaucoma surgery; cup/disc ratio; and best-corrected visual acuity (BCVA) were recorded. Patients with prior incisional glaucoma surgery were excluded. Surgical success was determined for both IOP <21 and <18 mm Hg and also ≥20% reduction from baseline without further glaucoma surgery. RESULTS: A total of 65 patients with primary open-angle glaucoma (POAG) and 39 patients with secondary open-angle glaucoma (SOAG), including pseudoexfoliative, pigmentary, uveitic, and steroid-induced glaucoma underwent GATT. Preoperative mean IOP was 25.0±7.3 mm Hg. Preoperative average number of antiglaucoma medications was 3.4±0.6. The average follow-up time was 19.4±8.1 (6 to 37) months. Preoperative average BCVA was 0.51±0.24, and cup/disc ratio was 0.85±0.14. Surgical success was achieved in 87 of 104 (83.7%). Seven patients had medically uncontrolled glaucoma after GATT surgery, and they underwent further surgery. Patients with POAG had a higher percentage of IOP reduction than patients with SOAG at 18th month of follow-up (40.1% vs. 27.6%). Need for medication at final visit was similar between POAG and SOAG. CONCLUSION: GATT procedure is a safe and successful option for the treatment of moderate to advanced open-angle glaucoma. Surgical success could be maintained up to ∼18 months.
Authors: Ercüment Bozkurt; Fatih Yenihayat; Ali Olgun; Ahmet Taylan Yazıcı; İbrahim Şahbaz Journal: Int Ophthalmol Date: 2020-08-31 Impact factor: 2.031
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