Abstract
Purpose :
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.
Methods :
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.
Results :
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.
Conclusions :
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.