Gonioscopy-Assisted Transluminal Trabeculotomy: Microinvasive Ab Interno Circumnavigation of Schlemm Canal: Mid-Term Results
Purpose
To report the midterm results of gonioscopy assisted transluminal trabeculotomy (GATT)
Methods
This is a noncomparative retrospective consecutive cases series of patients who underwent gonioscopy assisted transluminal trabeculotomy (GATT) at Glaucoma Associates of Texas between October 2011 and October 2013. Intraocular pressure (IOP), glaucoma medications, visual acuity, and intraoperative as well as postoperative complications were the main outcome measures.
Results
208 eyes of 168 consectutive patients aged 38 to 94 years underwent GATT and were followed an average of 19 months. 54 eyes were pseudophakic and 89 eyes underwent combined phaco-GATT. Among all patients, the IOP decreased an average of 5.4 to 5.9 mmHg [range of standard deviations, 6.5-10.5] at the 3 and 18 study month visits while the decrease in the number of glaucoma medications averaged 1.6 to 1.9 [range of SDs, 1.3 to 1.5]. Average IOP reduction at 18 months was 23.9%. There were significant differences in the cumulative proportion of eyes requiring glaucoma reoperation (p<0.01, log-rank test): phakic, 20.8%; prior CE, 34.4%; and combined procedure, 6.7% at 18 months of follow up. The most common complication was transient hyphema, seen in 27% of patients at the 1-week visit.
Conclusion
The mid-term results and safety profile for GATT, a novel, bleb-less, minimally invasive circumferential trabeculotomy are promising in POAG patients with the phakic and combined phaco-GATT groups having the most favorable results.