Abstract
Purpose :
Gonioscopy assisted transluminal trabeculotomy (GATT) has been shown to reduce intraocular pressure (IOP) in patients with open angle glaucoma with fewer complications than traditional glaucoma trabeculotomy or shunt surgery. However, the long-term efficacy in patients with primary open-angle glaucoma (POAG) and secondary open-angle glaucoma (SOAG) have yet to be determined. The purpose of this study was to describe single-surgeon two-year outcomes in patients following GATT alone or in combination with cataract surgery.
Methods :
This was a retrospective chart review of patients with primary and secondary open angle glaucoma who underwent GATT procedure at the Cole Eye Institute (Cleveland Clinic, Cleveland, Ohio, USA). The primary outcome was change in intraocular pressure and number of glaucoma medications used at two years. Secondary outcomes included number of patients who required additional glaucoma procedures or did not achieve a reduction in IOP or medication burden. Comparisons were performed using t-tests with non-parametric testing used as indicated.
Results :
A total of 92 eyes underwent GATT alone or with cataract surgery between December, 2015 and November, 2017. Forty-three (43) eyes were followed for an average of 729.4 +/- 47.7 days. Baseline IOP was 19.8 +/- 6.3 mmHg, and average change IOP was -7.3 +/-7.5 mmHg at two years (P<0.001). Baseline medication burden was 3.1+/-0.9 classes of medication, which drop by 1.7+/-1.4 medications at two years (P<0.001). The decline in IOP (-9.6+/-9.3 vs. -4.7+/-3.1mmHg) and medication burden (-2.3+/-1.2 vs. -1+/-1.2) was more pronounced in the SOAG group than the POAG group. Of the 92 eyes that underwent GATT, 19 (12 eyes with POAG, 7 eyes with SOAG) failed: 17 eyes required additional glaucoma procedures and 2 eyes did not have a significant decline in IOP or decrease in medication burden. Average time to additional procedure was 404.8 days, ranging from 100-903 days after GATT. Eyes who received additional glaucoma procedures were excluded from the two-year analysis. There were no major complications related to the GATT procedure at two-years of follow-up.
Conclusions :
GATT can effectively reduce IOP and medication burden two years after the initial procedure.
This is a 2020 ARVO Annual Meeting abstract.