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. 2021 Jul;105(7):977-982.
doi: 10.1136/bjophthalmol-2020-315954. Epub 2020 Jul 29.

Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up

Eamon Sharkawi #  1 , Daniel Josef Lindegger  2 , Paul H Artes  3   4 , Lydia Lehmann-Clarke  5 , Mohamad El Wardani  6 , Marie Misteli  6 , Jérôme Pasquier  7 , Adriano Guarnieri #  5
Affiliations

Outcomes of gonioscopy-assisted transluminal trabeculotomy in pseudoexfoliative glaucoma: 24-month follow-up

Eamon Sharkawi et al. Br J Ophthalmol. 2021 Jul.

Abstract

Aim: To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with pseudoexfoliative glaucoma (PXG).

Methods: Prospective, interventional, non-comparative case series. A total of 103 eyes from 84 patients with PXG were enrolled to undergo a 360-degree ab interno trabeculotomy with gonioscopic assistance using either a 5.0 polypropylene suture or an illuminated microcatheter with up to 24 months of follow-up. Main outcome measures were intraocular pressure (IOP), number of antiglaucoma medications, success rate (IOP reduction ≥20% from baseline or IOP between 6 and 21 mm Hg, without further glaucoma surgery) and complication rate.

Results: Mean preoperative IOP was 27.1 mm Hg (95% CI 25.5 to 28.7) using 2.9 (SD 1.1) glaucoma medications which decreased postoperatively to 13.0 mm Hg (95% CI 11.5 to 14.4) and 1.0 (SD 1.1) medications at 24 months (p<0.001). Success rate was 89.2% at 24 months of follow-up, and complication rate was 2.9%.

Conclusion: At 24 months of follow-up, our results for GATT in PXG demonstrate that this conjunctival sparing procedure effectively lowers IOP and reduces the medications with a low complication rate, in this relatively aggressive glaucoma subtype.

Keywords: Glaucoma; intraocular pressure; treatment surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Intraocular pressure (IOP) and number of medications at each time point over 24 months of follow-up. Each eye is represented with different colours according to number of medications and with different symbols if continuing visit (dot) or if the time point represented the last visit (censoring). The number of eyes and mean values are shown on the abscissa. The red circle represents the mean IOP value at each time point. d, days; m, months; w, weeks.
Figure 2
Figure 2
Scattergram of preoperative intraocular pressure (IOP) value (on the abscissa) and postoperative value (on the ordinate) at 6 months, 12 months, 18 months and 24 months of follow-up. The diagonal 45° line (solid black) indicates no change. Values between cut-off green lines at 6 and 21 mm Hg and under the diagonal that represents a 20% IOP decrease are classified as surgical success. Successful cases are spotted over a light green background.
See this image and copyright information in PMC

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