Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up.
Sharkawi Eamon, Lindegger Daniel Josef, Artes Paul H, Lehmann-Clarke Lydia, El Wardani Mohamad, Misteli Marie, Pasquier Jérôme, Guarnieri Adriano
AI Summary
GATT effectively lowered IOP and medication use in pseudoexfoliative glaucoma patients for 24 months with a high success rate and low complications, offering a valuable treatment option for this aggressive subtype.
Abstract
Aim
To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG).
Methods
Prospective, interventional, non-comparative case series. A total of 103 eyes from 84 patients with PXG were enrolled to undergo a 360-degree ab interno trabeculotomy with gonioscopic assistance using either a 5.0 polypropylene suture or an illuminated microcatheter with up to 24 months of follow-up. Main outcome measures were intraocular pressure (IOP), number of antiglaucoma medications, success rate (IOP reduction ≥20% from baseline or IOP between 6 and 21 mm Hg, without further glaucoma surgery) and complication rate.
Results
Mean preoperative IOP was 27.1 mm Hg (95% CI 25.5 to 28.7) using 2.9 (SD 1.1) glaucoma medications which decreased postoperatively to 13.0 mm Hg (95% CI 11.5 to 14.4) and 1.0 (SD 1.1) medications at 24 months (p<0.001). Success rate was 89.2% at 24 months of follow-up, and complication rate was 2.9%.
Conclusion
At 24 months of follow-up, our results for GATT in PXG demonstrate that this conjunctival sparing procedure effectively lowers IOP and reduces the medications with a low complication rate, in this relatively aggressive glaucoma subtype.
MeSH Terms
Shields Classification
Key Concepts5
Gonioscopy-assisted transluminal trabeculotomy (GATT) effectively lowered intraocular pressure (IOP) in eyes with pseudoexfoliative glaucoma (PXG) from a mean preoperative IOP of 27.1 mm Hg (95% CI 25.5 to 28.7) to 13.0 mm Hg (95% CI 11.5 to 14.4) at 24 months postoperatively (p<0.001).
Gonioscopy-assisted transluminal trabeculotomy (GATT) reduced the number of antiglaucoma medications in eyes with pseudoexfoliative glaucoma (PXG) from a mean of 2.9 (SD 1.1) preoperatively to 1.0 (SD 1.1) at 24 months postoperatively (p<0.001).
The success rate for gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG) was 89.2% at 24 months of follow-up, defined as IOP reduction ≥20% from baseline or IOP between 6 and 21 mm Hg, without further glaucoma surgery.
The complication rate for gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG) was 2.9% at 24 months of follow-up.
Gonioscopy-assisted transluminal trabeculotomy (GATT) involves a 360-degree ab interno trabeculotomy with gonioscopic assistance using either a 5.0 polypropylene suture or an illuminated microcatheter.
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