[Safety and efficacy of gonioscopy-assisted transluminal trabeculotomy (GATT) - A single-center retrospective study]

Glaucoma is a major cause of irreversible blindness worldwide. Many glaucoma patients will require surgical intervention during their lifetime, and traditional surgery carries risks and a significant failure rate. Transluminal trabeculotomy assisted by gonioscopy (GATT) is a minimally invasive glaucoma surgery aimed at reducing complication rates while lowering intraocular pressure. GATT is indicated for the treatment of primary and secondary open-angle glaucoma in adults and children. It is particularly suitable for cases involving secondary trabecular meshwork alterations, such as uveitic glaucoma, pseudoexfoliative glaucoma, and pigmentary glaucoma, among others. We describe a literature review and a retrospective case series of 37 eyes that underwent GATT. Mean preoperative IOP was approximately 20mmHg, decreasing significantly to 14.6mmHg at 6 months and to approximately 15mmHg at 12 months postoperatively. Surgical success, defined as a ≥ 20% reduction in intraocular pressure compared with the preoperative value, without severe complications or the need for secondary glaucoma surgery, was 99.83% at 6 months and 94.81% at 12 months. These results confirm the effectiveness of GATT in routine clinical practice, with a favorable safety profile and preservation of the conjunctiva for potential future surgical interventions, in agreement with previously published studies reporting success rates ranging from 46% at 18 months to 89% at 2 years, and approximately 75% at 3 years.