Surgical Success and Predictive Factors in Patients Undergoing Gonioscopy-Assisted Transluminal Trabeculotomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Open-angle glaucoma requires effective surgical interventions to manage intraocular pressure (IOP).
• Gonioscopy-assisted transluminal trabeculotomy (GATT) is a minimally invasive glaucoma surgery.
• Evaluating the long-term efficacy and prognostic factors of GATT is crucial for clinical practice.

Purpose of the Study:

• To assess the one-year surgical success rate of gonioscopy-assisted transluminal trabeculotomy (GATT).
• To identify prognostic factors influencing surgical outcomes in patients with open-angle glaucoma undergoing GATT.

Main Methods:

• Retrospective analysis of 225 eyes (214 patients) treated with GATT.
• Data collected included preoperative and 12-month postoperative intraocular pressure (IOP).
• Surgical success defined by IOP targets (5-18 mmHg) or ≥30% IOP reduction without further surgery.

Main Results:

• Mean preoperative IOP of 26.7 mmHg decreased to 14.3 mmHg at 12 months (p<0.05).
• Complete surgical success (Criterion A) was 41.3%; overall success was 87.6%.
• Higher preoperative IOP, longer axial length, and postoperative IOP spikes were associated with surgical failure. Circumferential (360°) GATT showed higher success rates than hemi-GATT.

Conclusions:

• GATT is an effective and safe surgical option for open-angle glaucoma.
• Higher preoperative IOP, longer axial length, and postoperative IOP spikes are risk factors for failure.
• Circumferential GATT and its potential use in complex glaucoma cases warrant further consideration.