Anterior Segment Changes after Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Pseudophakic Patients with...

We aimed to evaluate the anterior segment parameters and refractive changes after Gonioscopy-Assisted Transluminal Trabeculotomy (GATT).

This retrospective, cross-sectional, observational study included 21 eyes of 19 patients with open-angle glaucoma who underwent at least 180° GATT between February 2022 and January 2024. The anterior segment parameters obtained using Sirius corneal topography (CSO, Italy) were retrospectively reviewed for the preoperative period and the 3rd postoperative month.

Among the study population, fourteen eyes were diagnosed with primary open-angle glaucoma, six with pseudoexfoliative glaucoma, and one with pigmentary glaucoma. Compared to the preoperative period, the postoperative intraocular pressure (IOP) and the number of antiglaucomatous drugs (NAGD) used were significantly lower (23 [15-35] mmHg vs. 14 [7-19] mmHg, P<0.001; 4 [1-4] vs. 0 [0-3], P<0.001, respectively). Compared to the preoperative period, there were significant increases in the postoperative anterior chamber angle (ACA) (38 [27-55]° vs. 52 [35-62]°, P<0.001), anterior chamber depth (ACD) (2.67 [1.93-3.82] mm vs. 3.36 [2.7-4.25] mm, P<0.001), and anterior chamber volume (ACV) (111 [87-208] mm³ vs. 155 [110-252] mm³, P=0.001). No significant differences were detected in K1, K2, spherical equivalent (SE), best-corrected visual acuity (BCVA), or central corneal thickness (CCT) before and after GATT (P>0.05).

In our study, a decrease in IOP and the NAGD used, as well as an increase in ACA, ACD, and ACV, were observed after GATT compared to the preoperative period. The lack of changes in K1, K2, SE, BCVA, and CCT suggests that the surgery may be advantageous in these aspects.