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Carlos Matos Neto, Marco Antonio Rey de Faria, Gabriela de Sousa Martins Melo de Araujo, Rafael Barbosa de Araujo, Bruno Mendes de Faria; Gonioscopy-assisted Transluminal Trabeculotomy (GATT) outcomes in eyes with treatment resistant open angle glaucoma.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):458.
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© ARVO (1962-2015); The Authors (2016-present)
Primary open angle glaucoma is a leading cause of irreversible blindness around the world with only a handful of treatment options. Ab externo trabeculotomy have been successfully performed over 50 years in lowering intraocular pressure (IOP) without bleb formation. Recently, an ab interno approach termed gonioscopy-assisted transluminal trabeculotomy (GATT) was described as a minimally invasive glaucoma surgery (MIGS). This study aims to report the outcomes and reproducibility of this procedure in eyes with open angle glaucoma resistant to full topical treatment.
Sixteen eyes from 16 patients with treatment resistant glaucoma submitted to the GATT procedure were retrospectively reviewed. Pre-operative IOP was compared with IOP levels in days 1, 7, 30, 60, 90 and 120 of follow-up. Surgical complications were noted.
Mean age was 60.5 (±15.5) years old. Mean preoperative IOP was 33.13 (±7.7) mmHg. Follow-up IOP measurements in days 1, 7, 30, 60, 90 and 120 were, respectively: 11.50 (±3.9) mmHg, 12.62 (±2.7) mmHg, 12.31 (±1.9) mmHg, 11.94 (±1.2) mmHg, 11.75 (±1.3) mmHg and 12.15 (±1.2) mmHg. Comparison of all follow-up IOP averages with mean pre-operative IOP were statistically significant (p<0.001). Of all patients, 5 (31.3%) were submitted to cataract surgery associated to GATT. Nine patients (56.3%) developed hyphema within the first week of follow-up; hyphema was spontaneously absorbed in all cases. Five patients (31.3%) needed reintroduction of topical medication for controlling IOP levels in some point of follow-up.
GATT appears to be a safe, minimally invasive and successful procedure in lowering IOP levels in open angle glaucoma patients. In our study, it achieved the target IOP levels in 68.8% of the cases without need of hypotensive drugs. More studies are still necessary to assess the reproducibility and longer follow-up outcomes of this procedure.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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