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Gonioscopy-assisted transluminal trabeculotomy in primary angle-closure glaucoma

  • Glaucoma
  • Published:
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Abstract

Purpose

This study aims to report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with primary angle-closure glaucoma (PACG).

Methods

This study is a prospective, interventional, non-comparative case series. A total of 103 eyes from 88 patients with PACG underwent an ab interno trabeculotomy, using either a 5.0 polypropylene suture or an illuminated microcatheter, with up to 24 months of follow-up. The main outcome measures were intraocular pressure (IOP), number of antiglaucoma medications, success rate (IOP reduction ≥ 20% from baseline or IOP between 6 and 21 mmHg, without further glaucoma surgery) and complication rate.

Results

The mean preoperative IOP was 21.4 (SD 7.4) mmHg using 2.5 (SD 1.1) glaucoma medications. These decreased postoperatively to 12.1 (SD 2.4) mmHg and 0.8 (SD 1.2) medications, at 24 months (P < 0.05). Success rate was 78% at 24 months of follow-up, and complication rate was 4.8%.

Conclusion

At 24 months of follow-up, our results for GATT in PACG demonstrate that this procedure effectively lowers IOP in this subtype of glaucoma, with a low complication rate.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Swiss Eye Centre, Avenue de Rumine 64, Lausanne, 1005, Switzerland

    Eamon Sharkawi, Maria Laura Dari & Adriano Guarnieri

  2. University of Plymouth, Plymouth, UK

    Paul H. Artes

  3. Southwest Eye Institute, Tavistock, UK

    Paul H. Artes

  4. Jules Gonin Eye Hospital, Lausanne, Switzerland

    Daniel Josef Lindegger

  5. Moorfields Eye Hospital, London, UK

    Mohamad El Wardani

  6. Center for Primary Care and Public Health, Unisanté, University of Lausanne, Lausanne, Switzerland

    Jérôme Pasquier

Authors
  1. Eamon Sharkawi
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  2. Paul H. Artes
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  3. Daniel Josef Lindegger
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  4. Maria Laura Dari
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  5. Mohamad El Wardani
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  6. Jérôme Pasquier
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  7. Adriano Guarnieri
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Contributions

ES: conception and drafting the article. PHA: drafting the article and analysis and interpretation of data. DJL: drafting the article and acquisition of data. MLD: revising the article and acquisition of data. MEW: revising the article and acquisition of data. JP: analysis of data and revising the article. AG: drafting the article and analysis and interpretation of data. ES, PHA, and AG were involved in revising the article critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eamon Sharkawi.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Commission Cantonale d’Ethique, Canton of Vaud, Switzerland.

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Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Sharkawi, E., Artes, P.H., Lindegger, D.J. et al. Gonioscopy-assisted transluminal trabeculotomy in primary angle-closure glaucoma. Graefes Arch Clin Exp Ophthalmol 259, 3019–3026 (2021). https://doi.org/10.1007/s00417-021-05244-7

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  • DOI: https://doi.org/10.1007/s00417-021-05244-7

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