Gonioscopy-assisted transluminal trabeculotomy is an effective surgical treatment for uveitic glaucoma. Issue 5 (20th December 2021)

• Record Type: Journal Article
• Authors: Belkin, Avner; Chaban, Yuri Valere; Waldner, Derek; Samet, Saba; Ahmed, Iqbal Ike K; Gooi, Patrick; Schlenker, Matthew B
• Is Part Of: British journal of ophthalmology. Volume 107:Issue 5(2023)
• Page Start: 690
• Page End: 697
• Publication Date: 2021-12-20
• Subjects: treatment surgery -- glaucoma; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2021-320270
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: To assess the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in uveitic glaucoma (UG). Methods: A retrospective interventional case series in which 33 eyes of 32 patients with UG underwent GATT with or without concomitant cataract extraction and intraocular lens implantation (CE/IOL) at three Canadian treatment centres from October 2015 to 2020. The main outcome measure was surgical success defined as an intraocular pressure (IOP) ≤18 mm Hg and at least one of the following: IOP within one mm Hg of baseline on fewer glaucoma medications as compared with baseline or a 30% IOP reduction from baseline on the same or fewer medications. Secondary outcome measures were IOP, medication usage and surgical complications. Results: Mean patient age (mean±SD) was 49±16 years (range: 18–79) and 44% were female. GATT was performed as a standalone procedure in 52% of cases and the remainder were combined with CE/IOL. Surgical success was achieved in 71.8% (SE: 8.7%) of cases. Mean preoperative IOP (±SD) was 31.4±10.8 mm Hg on a median of 4 medications. 59% of patients were on oral carbonic anhydrase inhibitors (CAIs) prior to surgery. After 1 year, average IOP was 13.8 mm Hg on a median 1 medication, with 6% of patients being on oral CAIs. No sight threatening complications occurred during surgery or follow-up. Conclusion: GATT is an effective surgical strategy in the management of UG. This microinvasive conjunctival-sparing procedure should be considered early in these patients.