Gonioscopy assisted transluminal trabeculotomy: an ab interno circumferential trabeculotomy for the treatment of primary congenital glaucoma and juvenile open angle glaucoma.
Grover Davinder S, Smith Oluwatosin, Fellman Ronald L, Godfrey David G, Butler Michelle R, Montes de Oca Ildamaris, Feuer William J
AI Summary
Gonioscopy assisted transluminal trabeculotomy (GATT) effectively reduced IOP and medication dependence in primary congenital and juvenile open-angle glaucoma patients, demonstrating promising safety and efficacy comparable to established treatments.
Abstract
Background/aims: To introduce a novel ab interno 360° trabeculotomy for treating primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG) and report preliminary results.
Methods
A retrospective chart review of patients who underwent a gonioscopy assisted transluminal trabeculotomy (GATT) procedure by four of the authors (DSG, OS, RLF and DGG) between October 2011 and October 2013. The surgery was performed in patients ≤30 years old with a dysgenic anterior segment angle and uncontrolled PCG and JOAG.
Results
Fourteen eyes of 10 patients underwent GATT with follow-up >12 months (12-33 months; mean 20.4). Patients ranged in age from 17 months to 30 years (mean=18.4 years), and five (50%) were female patients. No complications occurred during or following surgery except for early postoperative hyphema in five (36%) of eyes, all cleared by 1 month. The mean intraocular pressure (IOP) decreased from 27.3 to 14.8 mm Hg and the mean number of medications required decreased from 2.6 to 0.86. Five eyes had a drop in IOP ≥15 mm Hg (range 15-39).
Conclusions
The preliminary results and safety for GATT, a minimally invasive conjunctival sparing circumferential trabeculotomy, are promising and at least equivalent to previous results for ab externo trabeculotomy for the treatment of PCG and JOAG. All eyes in the study were considered a clinical success.
MeSH Terms
Shields Classification
Key Concepts6
The mean intraocular pressure (IOP) decreased from 27.3 to 14.8 mm Hg after gonioscopy assisted transluminal trabeculotomy (GATT) in 14 eyes of 10 patients with primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG).
The mean number of medications required decreased from 2.6 to 0.86 after gonioscopy assisted transluminal trabeculotomy (GATT) in 14 eyes of 10 patients with primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG).
Early postoperative hyphema occurred in five (36%) of eyes after gonioscopy assisted transluminal trabeculotomy (GATT), all of which cleared by 1 month, with no other complications reported.
The preliminary results and safety for gonioscopy assisted transluminal trabeculotomy (GATT) for the treatment of primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG) are promising and at least equivalent to previous results for ab externo trabeculotomy.
Gonioscopy assisted transluminal trabeculotomy (GATT) is a novel ab interno 360° trabeculotomy for treating primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG).
Gonioscopy assisted transluminal trabeculotomy (GATT) was performed in patients ≤30 years old with a dysgenic anterior segment angle and uncontrolled primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG).
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