Gonioscopy-assisted transluminal trabeculotomy outcomes in patients with highly advanced glaucoma.
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
AI Summary
GATT effectively lowered IOP and medication burden in highly advanced glaucoma patients, showing it's a safe and viable surgical option for this challenging group.
Abstract
Background/objectives: No data regarding the outcomes of GATT in patients with highly advanced glaucoma are available. The aim of this study is to fill in this gap.
Subjects/Methods
This is a multicentre, retrospective, and case-control study including highly advanced glaucoma patients (HVF Mean Deviation, MD < -20 dB, study group-SG) and controls (CG: MD > -20 dB). Sixty eyes (31 GATT stand-alone and 29 Phaco-GATT eyes) were included in each group. The SG and CG were compared until 12 months of follow-up, and survival analyses were performed.
Results
The preoperative MD was -25.95 ± 3.64 dB in the SG and -7.96 ± 5.25 dB in the CG (p < 0.001). Preoperative IOP was 21.5 ± 8.2 mmHg in the SG on 3.4 ± 1.4 medications, and 20.8 ± 7.3 mmHg in the CG (p = 0.6) on 3.0 ± 0.9 medications (p = 0.1). At the 12-month visit, IOP was reduced by 39.1 ± 26.6% in the SG and 36.0 ± 18.7% in the CG (p = 0.4), and the number of preoperative medications was reduced by 62.2 ± 33.2% in the SG and 65.5 ± 37.4% in the CG (p = 0.6), with 93.3% of the eyes in the SG and 90.0% of the eyes in the CG having an IOP ≤ 14 mmHg, with or without medication (p = 0.5). No serious adverse events were observed in any of the groups.
Conclusion
GATT is a safe and effective surgical option for patients with highly advanced glaucoma.
MeSH Terms
Shields Classification
Key Concepts6
At the 12-month visit, intraocular pressure (IOP) was reduced by 39.1 ± 26.6% in highly advanced glaucoma patients undergoing Gonioscopy-assisted transluminal trabeculotomy (GATT) and 36.0 ± 18.7% in controls (p = 0.4).
At the 12-month visit, the number of preoperative medications was reduced by 62.2 ± 33.2% in highly advanced glaucoma patients undergoing Gonioscopy-assisted transluminal trabeculotomy (GATT) and 65.5 ± 37.4% in controls (p = 0.6).
At the 12-month visit, 93.3% of eyes in highly advanced glaucoma patients undergoing Gonioscopy-assisted transluminal trabeculotomy (GATT) and 90.0% of eyes in controls had an IOP ≤ 14 mmHg, with or without medication (p = 0.5).
No serious adverse events were observed in highly advanced glaucoma patients or controls undergoing Gonioscopy-assisted transluminal trabeculotomy (GATT).
The preoperative Mean Deviation (MD) was -25.95 ± 3.64 dB in highly advanced glaucoma patients (study group) and -7.96 ± 5.25 dB in controls (p < 0.001).
Preoperative intraocular pressure (IOP) was 21.5 ± 8.2 mmHg in highly advanced glaucoma patients on 3.4 ± 1.4 medications, and 20.8 ± 7.3 mmHg in controls on 3.0 ± 0.9 medications (p = 0.6 for IOP, p = 0.1 for medications).
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