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Comparison of combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction with gonioscopy-assisted transluminal trabeculotomy surgery alone on macular thickness

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Abstract

Purpose

To evaluate the effect of Gonioscopy-assisted transluminal trabeculotomy (GATT) on macular thickness and to compare the combined GATT and cataract extraction (CE) with GATT surgery alone regarding macular thickness.

Methods

A retrospective, comparative study was designed. The patients who underwent GATT or combined GATT and CE with preoperative and regular postoperative spectral domain optic coherence tomography analysis (SD-OCT) were included. The macula was visualized in a 5 × 5 mm2 area by SD-OCT using MM5 mode. Two different groups were defined as follows: group 1 enrolled patients who underwent GATT alone, and group 2 enrolled patients who underwent combined GATT and CE. Pre- and postoperative macular thickness measurements by performing intragroup analysis and comparing group 1 with group 2 with regard to change in macular thickness were assessed.

Results

Fifty-four eyes fulfilled the inclusion criteria and were enrolled in this study, (Group 1 = 29 eyes, Group 2 = 25 eyes). The mean thicknesses of central macula (CM), superior inner macula (SIM), and nasal inner macula (NIM) significantly increased 1 month after GATT alone (p < 0.05). This difference became statistically insignificant at 3rd month after the surgery, (p > 0.05). The mean thicknesses of SIM, temporal inner macula (TIM), NIM, superior outer macula (SOM), inferior outer macula (IOM), and temporal outer macula (TOM) showed a significant increase 1 month after combined GATT and CE, (p < 0.05), which return its preoperative levels 3 months after the surgery (p > 0.05). There was no significant difference between group 1 and group 2 with regard to change in macular thickness at each time points, (p > 0.05). Postoperative clinically significant CME was observed in one patient who underwent GATT alone (p = 0.351).

Conclusion

GATT can be a safe procedure with minimal and transient adverse effect on macular thickness and structure. Performing GATT together with CE caused no additional increase in the risk of macular thickening.

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Authors and Affiliations

  1. Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey

    Mehmet Ozgur Cubuk & Hulya Gungel

  2. Department of Ophthalmology, Agrı Patnos State Hospital, Agrı, Turkey

    Armagan Filik

  3. Department of Ophthalmology, Abant Izzet Baysal University, Izzet Baysal Training and Research Hospital, Bolu, Turkey

    Ahmet Yucel Ucgul

Authors
  1. Mehmet Ozgur Cubuk
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  2. Armagan Filik
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  3. Ahmet Yucel Ucgul
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  4. Hulya Gungel
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Correspondence to Mehmet Ozgur Cubuk.

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Author MOC declares that he has no conflict of interest. Author AF declares that he has no conflict of interest. Author AYU declares that he has no conflict of interest. Author HG declares that she has no conflict of interest.

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Cubuk, M.O., Filik, A., Ucgul, A.Y. et al. Comparison of combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction with gonioscopy-assisted transluminal trabeculotomy surgery alone on macular thickness. Int Ophthalmol 43, 105–112 (2023). https://doi.org/10.1007/s10792-022-02392-5

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  • DOI: https://doi.org/10.1007/s10792-022-02392-5

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