Pattern of Long-Term Intraocular Pressure Variation Following Gonioscopy-Assisted Transluminal Trabeculotomy: Two-Year Outcomes.
Faria Bruno M, Dias Diego T, Reis Mariana A O, Daga Fabio B, Scoralick Ana L B, Magacho Leopoldo, Ribeiro Junior Pedro H E, Kanadani Fabio N, Costa Vital P, Prata Tiago S
AI Summary
GATT/PHACOGATT effectively lowered and stabilized long-term IOP in uncontrolled open-angle glaucoma patients for two years, suggesting these procedures are viable for achieving stable, low pressures.
Abstract
Précis: Patients with clinically uncontrolled open angle glaucoma submitted to isolated gonioscopy-assisted transluminal trabeculotomy or combined with phacoemulsification not only achieved low mean IOPs, but also demonstrated stable IOP patterns during a 24-month follow-up.
Purpose
To assess the impact of gonioscopy-assisted transluminal trabeculotomy (GATT) on long-term intraocular pressure (IOP) variation.
Patients and methods: An unicentric retrospective study including 169 consecutive patients who had undergone standalone GATT or combined with phacoemulsification (PHACOGATT) due to clinically uncontrolled open angle glaucoma, with at least 12 months of follow-up was conducted. Long-term mean IOP, long-term IOP peak, long-term IOP fluctuation, coefficient of variation, mean-positive IOP variation, sustained clinically significant positive IOP variation, and number of follow-up visits with IOP ≥15 mm Hg were investigated.
Results
One hundred sixty-nine eyes from 169 patients were included (GATT group=101 patients; PHACOGATT group=68 patients). Mean long term IOP (12.0±1.8 vs. 11.2±2.0 mm Hg), mean long-term IOP peak (12.9±2.6 vs. 11.8±3.5 mm Hg), and mean coefficient of variation (0.07±0.08 vs. 0.05±0.09) were lower in the PHACOGATT group, while mean IOP fluctuation (1.0±3.7 vs. 1.2±1.8 mm Hg) was lower in the GATT group. In addition, the overall mean-positive IOP variation was 0.79±1.64 mm Hg. Finally, only 6.5% of the patients presented sustained clinically significant positive IOP variation and IOP was ≥15 mm Hg in 5.9% of the follow-up visits.
Conclusions
Patients with clinically uncontrolled open angle glaucoma submitted to GATT or PHACOGATT achieved low mean IOPs and demonstrated stable IOP patterns. Our results provide additional evidence supporting GATT and PHACOGATT as viable options for the treatment of medically uncontrolled glaucoma patients requiring low and stable IOPs.
MeSH Terms
Shields Classification
Key Concepts6
Patients with clinically uncontrolled open angle glaucoma who underwent isolated gonioscopy-assisted transluminal trabeculotomy (GATT) or combined with phacoemulsification (PHACOGATT) achieved low mean intraocular pressures (IOPs) and demonstrated stable IOP patterns over a 24-month follow-up period.
In a retrospective study of 169 patients with clinically uncontrolled open angle glaucoma, the PHACOGATT group (68 patients) demonstrated lower mean long-term IOP (11.2±2.0 mm Hg) compared to the GATT group (101 patients) with a mean long-term IOP of 12.0±1.8 mm Hg.
In a retrospective study of 169 patients with clinically uncontrolled open angle glaucoma, the PHACOGATT group (68 patients) showed a lower mean long-term IOP peak (11.8±3.5 mm Hg) compared to the GATT group (101 patients) with a mean long-term IOP peak of 12.9±2.6 mm Hg.
In a retrospective study of 169 patients with clinically uncontrolled open angle glaucoma, the mean coefficient of variation for intraocular pressure was lower in the PHACOGATT group (0.05±0.09) compared to the GATT group (0.07±0.08).
In a retrospective study of 169 patients with clinically uncontrolled open angle glaucoma, the mean intraocular pressure fluctuation was lower in the GATT group (1.0±3.7 mm Hg) compared to the PHACOGATT group (1.2±1.8 mm Hg).
In a retrospective study of 169 patients with clinically uncontrolled open angle glaucoma undergoing GATT or PHACOGATT, only 6.5% of patients experienced sustained clinically significant positive intraocular pressure variation, and IOP was ≥15 mm Hg in 5.9% of follow-up visits.
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