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The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification

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Abstract

Purpose

To investigate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) with or without cataract extraction (CE) in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEX) patients.

Methods

A retrospective, non-randomized study included 108 eyes of 108 patients, with a mean age of 65.96 ± 14.84 years, who underwent GATT to treat open-angle glaucoma. We have compared two groups, GATT alone or GATT combined with CE and followed-up minimum for 12 months. Preoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA) compared with final IOP, medication numbers, and BCVA levels. Surgical success was determined as IOP reduction > 20% from baseline, IOP between 5–21 mmHg, if surgery was done for intolerance to medications, preoperative < 21 mmHg with medications, postoperatively < 21 mmHg without medications, and no need for further glaucoma surgery. Also, we defined success with medications and success without medications. High success is defined as IOP < 16 mmHg without medications.

Results

Success percentiles were found 87.5% for GATT and 83.8% for GATT with CE group (P = 0.811). IOP percentile changes were − 44.25 ± 21.32 in GATT group, − 32.29 ± 23.41 in GATT with CE group, statistically higher change observed in GATT group (P = 0.009). Final IOP levels were found statistically indifferent for comparing GATT and GATT with CE groups and between PEX and POAG groups (respectively, P = 0.412, P = 0.335).

Conclusion

We observed GATT alone has a superior lowering effect on IOP than combined surgery. Final IOP values and success percentiles show us combined surgery is also effective.

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Funding

This study has not any financial support.

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Authors and Affiliations

  1. World Eye Hospital, Altunizade, İstanbul, Turkey

    Ercüment Bozkurt, Ali Olgun & İbrahim Şahbaz

  2. World Eye Hospital, 41100, İzmit, Kocaeli, Turkey

    Fatih Yenihayat

  3. Smart Lens Inc, Santa Clara, CA, USA

    Ahmet Taylan Yazıcı

Authors
  1. Ercüment Bozkurt
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  2. Fatih Yenihayat
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  3. Ali Olgun
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  4. Ahmet Taylan Yazıcı
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  5. İbrahim Şahbaz
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Corresponding author

Correspondence to Fatih Yenihayat.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethical committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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

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Bozkurt, E., Yenihayat, F., Olgun, A. et al. The efficacy of gonioscopy-assisted transluminal trabeculectomy combined with phacoemulsification. Int Ophthalmol 41, 35–43 (2021). https://doi.org/10.1007/s10792-020-01550-x

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  • DOI: https://doi.org/10.1007/s10792-020-01550-x

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