Gonioscopy-Assisted Transluminal Trabeculotomy in Patients With Angle Recession Glaucoma

Gonioscopy-assisted transluminal trabeculotomy (GATT) is a successful minimally invasive glaucoma surgery (MIGS) technique for treating patients with angle recession glaucoma (ARG).

To share 1-year follow-up outcomes of GATT in patients with ARG.

Six eyes of 6 patients with ARG were reviewed in this retrospective study. All of the patients had uncontrolled intraocular pressure (IOP) with antiglaucoma medications (AGM) and a history of blunt ocular trauma (BOT). Preoperative IOP; the number of preoperative AGM; postoperative IOP at first month, third, sixth, and 12th months; postoperative IOP spikes, the need for postoperative AGM, and the need for further surgical interventions were recorded.

Five patients underwent GATT and 1 patient underwent GATT combined with phacoemulsification. IOP decreased from 30.30 [7.20] mm Hg preoperatively to 11.95 [3.45] mm Hg postoperatively at the 12th month (P=0.028), with a median difference of -19.50 mm Hg (95% CI: -25.10 to -14.55). After GATT, all patients had varying degrees of hyphema that did not require surgical intervention. IOP peaks were observed in the postoperative first month in 3 patients and IOP was controlled with AGM in these patients. The median (IQR) preoperative number of AGM decreased significantly compared with the median (IQR) postoperative number of AGM at the 12th month [P=0.038, 4.00 (0.25) vs. 2.00 (1.25), median difference: -1.50, 95% CI: -2.00 to -0.50]. During the 1-year follow-up, no patients with ARG required additional surgical intervention.

Due to its low complication rates and successful IOP-lowering effect, we recommended that GATT is an effective, safe, and considerable MIGS procedure for patients with ARG.