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Evaluation of peripheral anterior synechia formation following gonioscopy-assisted transluminal trabeculotomy surgery

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Abstract

Purpose

To quantitatively assess the development of peripheral anterior synechia (PAS) formation rate and PAS locations on gonioscopic examination following gonioscopy-assisted transluminal trabeculotomy (GATT) surgery and investigate the surgical outcomes.

Methods

A total of 35 eyes from 31 patients with open angle glaucoma who underwent GATT or combined GATT and phacoemulsification surgery were analyzed. Presence of PAS was assessed on gonioscopy in nasal, temporal, superior and inferior quadrants at months 1, 3 and 6 following surgery. Surgical outcomes were also noted.

Results

Frequencies of PAS formation were 38.3%, 25.3%, 17.0% and 19.1% at postoperative 1 month, 34.0%, 26.4%, 17% and 22.6% at postoperative 3 months and 32.3%, 25.8%, 16.1% and 25.8% at postoperative 6 months, in nasal, temporal, superior and inferior quadrants, respectively. The highest amount of PAS involvement was 3 clock hours in the study which was identified only in nasal and inferior quadrants. Frequency of PAS formation did not significantly differ between nasal, temporal, superior and inferior quadrants at all time points (p > 0.05). No significant differences of mean IOP levels were observed between patients who developed PAS and who did not develop PAS at postoperative 1 month (p = 0.72), 3 months (p = 0.21) and 6 months (p = 0.59). The mean IOP and mean number of antiglaucoma medications decreased from 31.5 ± 7.2 mmHg and 3.6 ± 0.6 at baseline to 13.8 ± 3.1 mmHg and 1.6 ± 1.3 at postoperative 6 months, respectively (p < 0.001, for both). Cumulative success rate (95% confidence interval) was 74.3% (69.9–78.6%) at the end of the study. Mild to moderate degrees of hyphema occurred in all cases postoperatively.

Conclusion

Although PAS formation was observed to be relatively higher in nasal quadrant, PAS frequency was not statistically different between the angle quadrants.

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Funding

The authors declare that no funds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Tip Fakultesi, Goz Hastaliklari Klinigi, Farabi Caddesi, 61080, Trabzon, Turkey

    Murat Gunay, Adem Turk, Hilal Ozturk, Fatma Tugba Bulanik & Dilek Uzlu

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  1. Murat Gunay
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  2. Adem Turk
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  3. Hilal Ozturk
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  4. Fatma Tugba Bulanik
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  5. Dilek Uzlu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection were performed by MG, and analysis was performed by AT, HO, FTB and DU. The first draft of the manuscript was written by MG and AT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Murat Gunay.

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Conflict of interest

The authors have no relevant financial or non-financial interest to disclose.

Ethical approval

This study was performed in line with the principles of Declaration of Helsinki. Approval was granted by the Ethics Committee of Karadeniz Technical University, Faculty of Medicine (2022 —136).

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

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Gunay, M., Turk, A., Ozturk, H. et al. Evaluation of peripheral anterior synechia formation following gonioscopy-assisted transluminal trabeculotomy surgery. Int Ophthalmol 43, 3045–3053 (2023). https://doi.org/10.1007/s10792-023-02704-3

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  • DOI: https://doi.org/10.1007/s10792-023-02704-3

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