Gonioscopy-assisted transluminal trabeculotomy outcomes in patients with highly advanced glaucoma

No data regarding the outcomes of GATT in patients with highly advanced glaucoma are available. The aim of this study is to fill in this gap.

This is a multicentre, retrospective, and case-control study including highly advanced glaucoma patients (HVF Mean Deviation, MD < -20 dB, study group-SG) and controls (CG: MD > -20 dB). Sixty eyes (31 GATT stand-alone and 29 Phaco-GATT eyes) were included in each group. The SG and CG were compared until 12 months of follow-up, and survival analyses were performed.

The preoperative MD was -25.95 ± 3.64 dB in the SG and -7.96 ± 5.25 dB in the CG (p < 0.001). Preoperative IOP was 21.5 ± 8.2 mmHg in the SG on 3.4 ± 1.4 medications, and 20.8 ± 7.3 mmHg in the CG (p = 0.6) on 3.0 ± 0.9 medications (p = 0.1). At the 12-month visit, IOP was reduced by 39.1 ± 26.6% in the SG and 36.0 ± 18.7% in the CG (p = 0.4), and the number of preoperative medications was reduced by 62.2 ± 33.2% in the SG and 65.5 ± 37.4% in the CG (p = 0.6), with 93.3% of the eyes in the SG and 90.0% of the eyes in the CG having an IOP ≤ 14 mmHg, with or without medication (p = 0.5). No serious adverse events were observed in any of the groups.

GATT is a safe and effective surgical option for patients with highly advanced glaucoma.