advertisement
Abstract #99299 Published in IGR 22-4
Gonioscopy-assisted Transluminal Trabeculotomy for Glaucoma: One-year Outcomes and Success Predictors
Faria BM; Costa VP; Melillo GHL; Daga FB; Scoralick ALB; Paranhos A; Kanadani FN; Prata TSJournal of Glaucoma 2022; 31: 443-448
PRCIS: Our results suggest gonioscopy-assisted transluminal trabeculotomy (GATT) as an effective and safe option for the surgical management of open-angle glaucoma. Older age was the only risk factor for failure in our analysis. PURPOSE: To report 12-month clinical outcomes, safety profile and success predictors of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open-angle glaucoma (OAG). PATIENTS AND METHODS: A retrospective study of patients (≥18▒y old) with medically uncontrolled OAG who underwent GATT as a solo procedure or combined with phacoemulsification (PHACO-GATT) between January 2018 and January 2020. Success at 12 months (primary outcome) was defined as IOP<15▒mmHg, with an IOP reduction of at least 20%, OR a reduction of at least 2 glaucoma medications, compared to baseline. Secondary outcomes were success predictors and safety parameters. RESULTS: A total of 73 eyes (GATT=38; PHACO-GATT=35) from 58 patients with a mean age of 54.8±11.6 years were included. Overall, after 12 months of follow-up, mean IOP was reduced from 24.9±8.5 to 12.1±2.1▒mmHg (P<0.001). The mean number of glaucoma medications was reduced from 3.5±0.7 to 1.2±1.2 (P<0.001). Success rate was 87% at 12 months, with no significant differences between GATT (85%) and PHACO-GATT (91%) eyes (P=0.330). Age was the only factor significantly associated with surgical success (HR=1.35; P=0.012; after adjusting for pre-operative IOP and number of glaucoma medications). Patients older than 60 years had a significant greater chance of failure (HR=10.96; P=0.026) compared to those younger than 60 years. Most common postoperative complication was transient hyphema (39%; median duration, 5▒d). No sight-threating adverse event was documented. CONCLUSIONS: GATT was effective and safe at lowering IOP with or without cataract extraction in OAG. Patients 60 years or older had a higher risk of failure compared to those younger in age.
Federal University of Rio Grande do Norte, Natal, Brazil.
Full article