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Wipe-Out Phenomenon After Gonioscopy-Assisted Transluminal Trabeculotomy.
Enver Mirza1, Gunsu Deniz Mirza2, Mehmet Adam1
1Department of Ophthalmology, Faculty of Medicine, Necmettin Erbakan University.
Journal of Glaucoma
|June 17, 2025
Summary
This case report details a rare instance of vision loss after gonioscopy-assisted transluminal trabeculotomy (GATT) in advanced pseudoexfoliation glaucoma. The wipe-out phenomenon caused irreversible vision loss despite successful intraocular pressure reduction.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Complications
Background:
- Pseudoexfoliation glaucoma is a common cause of secondary glaucoma.
- Advanced glaucoma often requires surgical intervention to preserve vision.
- Gonioscopy-assisted transluminal trabeculotomy (GATT) is an effective MIGS procedure.
Purpose of the Study:
- To report a rare case of the wipe-out phenomenon after GATT.
- To highlight the risk of irreversible vision loss in advanced glaucoma patients undergoing GATT.
Main Methods:
- A 71-year-old male with advanced pseudoexfoliation glaucoma underwent 360-degree GATT.
- Postoperative complications included sudden vision loss and cystoid macular edema (CME).
- Treatment involved anti-inflammatory agents and anti-VEGF injections.
Main Results:
- The patient experienced irreversible vision loss (hand motion) and CME post-GATT.
- Intraocular pressure (IOP) was controlled (11.1 mm Hg) with topical medications.
- CME resolved, but visual acuity did not improve.
Conclusions:
- The wipe-out phenomenon is a potential risk after GATT in advanced glaucoma.
- Careful patient selection is crucial for GATT in advanced glaucoma.
- Ophthalmologists should consider this rare complication when discussing GATT.
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