Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
Purpose: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. Methods: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical suc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3024;epage=3030;aulast=Dar |
| _version_ | 1797649294264631296 |
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| author | Nimrod Dar Liron Naftali Ben Haim Veronika Yehezkeli Tal Sharon Avner Belkin |
| author_facet | Nimrod Dar Liron Naftali Ben Haim Veronika Yehezkeli Tal Sharon Avner Belkin |
| author_sort | Nimrod Dar |
| collection | DOAJ |
| description | Purpose: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. Methods: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical success; intra-ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ≤ of baseline on fewer medications as compared to baseline. Results: Forty-seven eyes were included in the analysis. The average mean deviation was -17.5 ± 7.2 dB (range −8.0 to -33.0). The average follow-up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6th post-operative month (P < 0.001 for both IOP and medications). At the last follow-up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery. Conclusions: GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post-operative management are imperative. |
| first_indexed | 2024-03-11T15:45:05Z |
| format | Article |
| id | doaj.art-59d500dd484d4c2dbb7a4a8138c63655 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-03-11T15:45:05Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-59d500dd484d4c2dbb7a4a8138c636552023-10-26T06:49:07ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892023-01-017183024303010.4103/IJO.IJO_2769_22Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucomaNimrod DarLiron Naftali Ben HaimVeronika YehezkeliTal SharonAvner BelkinPurpose: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. Methods: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical success; intra-ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ≤ of baseline on fewer medications as compared to baseline. Results: Forty-seven eyes were included in the analysis. The average mean deviation was -17.5 ± 7.2 dB (range −8.0 to -33.0). The average follow-up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6th post-operative month (P < 0.001 for both IOP and medications). At the last follow-up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery. Conclusions: GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post-operative management are imperative.http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3024;epage=3030;aulast=Daradvanced glaucomaglaucoma surgerygonioscopy-assisted transluminal trabeculotomyintra-ocular pressure |
| spellingShingle | Nimrod Dar Liron Naftali Ben Haim Veronika Yehezkeli Tal Sharon Avner Belkin Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma Indian Journal of Ophthalmology advanced glaucoma glaucoma surgery gonioscopy-assisted transluminal trabeculotomy intra-ocular pressure |
| title | Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma |
| title_full | Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma |
| title_fullStr | Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma |
| title_full_unstemmed | Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma |
| title_short | Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma |
| title_sort | gonioscopy assisted transluminal trabeculotomy in patients with advanced glaucoma |
| topic | advanced glaucoma glaucoma surgery gonioscopy-assisted transluminal trabeculotomy intra-ocular pressure |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3024;epage=3030;aulast=Dar |
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