Abstract
Purpose :
To review five-year outcomes on the efficacy of Ab-interno GATT for the treatment of primary open angle (POAG) glaucoma, secondary open angle glaucoma (SOAG), and other glaucomas.
Methods :
A retrospective chart review was performed of all patients who underwent GATT at a single institution from 2011 to 2020. Patients who underwent previous glaucoma surgery, were diagnosed with juvenile or congenital glaucoma, had an IOP < 18 at pre-op or were under age 18 at the time of surgery were excluded. Pre-operative and post operative values for visual fields, IOP and medication numbers were collected throughout 60 months. Paired t-test was performed to compare pre-operative with post-operative measurements. Treatment success was defined as patients who did not require another operation to control pressure, maintained an IOP that was lowered by at least 20% from pre-operative levels at or after 6 months, and had IOP < 21mm Hg at and beyond 6 months of followup. Kaplan-Meier analysis was performed to analyze failure.
Results :
905 eyes met inclusion criteria. Of these, 190 eyes were followed through 60 months. In those who were successfully treated, the IOP decreased from 26.3 to 14.56 and the glaucoma medications needed decreased from 3.6 to 1.46 drops in patients who had follow up through 60 months. Analysis of groups classified by POAG, SOAG or “other Glaucomas” found lower failure rates in SOAG with Chi Square test demonstrating a difference in failure rates between groups (p<0.0001).
Conclusions :
In patients who did not fail treatment, GATT reduced the drop burden by greater than half and the IOP was much better controlled. When successful, GATT is an effective surgical treatment in glaucoma patients with uncontrolled IOP who have never had any glaucoma surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.