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Short-term endothelial cell density changes after gonioscopy-assisted transluminal trabeculotomy
Bruno Mendes de Faria1, Gustavo Henrique de Lima Melillo2, Fabio Daga3,4
1Hospital Universitário Onofre Lopes, Natal, RN, Brazil.
Arquivos Brasileiros De Oftalmologia
|December 1, 2021
Summary
Gonioscopy-assisted transluminal trabeculotomy (GATT) shows minimal corneal endothelial cell loss in short-term follow-up. This glaucoma surgery is safe for the corneal endothelium, whether performed alone or with cataract extraction.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Corneal Physiology
Background:
- Open-angle glaucoma management often requires surgical intervention to reduce intraocular pressure.
- Gonioscopy-assisted transluminal trabeculotomy (GATT) is an increasingly utilized minimally invasive glaucoma surgery.
- The impact of GATT on corneal endothelial cell density is a critical factor for long-term ocular health.
Purpose of the Study:
- To evaluate the short-term reduction in corneal endothelial cell density following gonioscopy-assisted transluminal trabeculotomy (GATT).
- To compare endothelial cell loss between isolated GATT and combined phaco-GATT procedures.
- To assess the safety of GATT concerning the corneal endothelium.
Main Methods:
- Retrospective analysis of medical charts for open-angle glaucoma patients undergoing GATT (isolated or combined with phacoemulsification) or phacoemulsification alone (controls).
- Endothelial cell density was measured using specular microscopy before and one month after surgery.
- Statistical comparison of cell density reduction between groups.
Main Results:
- Sixty-two eyes were analyzed (39 isolated GATT, 23 combined phaco-GATT).
- Mean endothelial cell density reduction was 1.31% for isolated GATT (p=0.467) and 4.36% for phaco-GATT (p=0.028).
- Phaco-GATT showed a cell density reduction not significantly different from controls (4.41%, p=0.81).
Conclusions:
- Gonioscopy-assisted transluminal trabeculotomy (GATT), both isolated and combined with phacoemulsification, demonstrates safety for the corneal endothelial cell layer.
- Short-term follow-up suggests minimal endothelial cell loss, supporting GATT as a viable glaucoma treatment option.
- Further long-term studies are warranted to confirm sustained endothelial cell health post-GATT.
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