Dataset Information

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results.

ABSTRACT:

Purpose

To evaluate the one-year outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in primary congenital glaucoma (PCG) with a history of prior glaucoma surgery.

Methods

A retrospective chart review was performed to identify all PCG patients ≤ 16 years who underwent GATT surgery at Cairo University Children's Hospital from January 2016 to March 2022. Pre- and postoperative intraocular pressure (IOP) and glaucoma medications were collected at 1, 3, 6, 9, 12, and last follow-up visits. Success was defined as IOP ≤ 21 mmHg without (complete) or with (qualified) glaucoma medications at the last follow-up.

Results

Seven eyes of 6 subjects were included in the study. The mean IOP was statistically significantly reduced from 25.7 ± 5.9 mmHg preoperatively to a mean IOP of 12 ± 1.5 mmHg (P = 0.001) at 12 months and 11.5 ± 1.2 mmHg (P = 0.001) at the last follow-up visit. Six eyes (85.7%) achieved complete success, and one eye (14.2%) achieved qualified success. No patients required further glaucoma procedures. No serious intra- or postoperative complications were identified.

Conclusions

Our early experience highlights that GATT can be performed as an alternative procedure before considering conjunctival or scleral glaucoma surgeries.

SUBMITTER: Elhusseiny AM

PROVIDER: S-EPMC10250098 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results.

Elhusseiny Abdelrahman M AM Aboulhassan Reem M RM El Sayed Yasmine M YM Gawdat Ghada I GI Elhilali Hala M HM

Case reports in ophthalmological medicine 20230601

<h4>Purpose</h4>To evaluate the one-year outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in primary congenital glaucoma (PCG) with a history of prior glaucoma surgery.<h4>Methods</h4>A retrospective chart review was performed to identify all PCG patients ≤ 16 years who underwent GATT surgery at Cairo University Children's Hospital from January 2016 to March 2022. Pre- and postoperative intraocular pressure (IOP) and glaucoma medications were collected at 1, 3, 6, 9, 12, and las ...[more]

PMID: 37304219

Similar Datasets

Project description:BackgroundTo compare the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) and Kahook Dual Blade (KDB) excisional goniotomy in patients with uncontrolled juvenile open-angle glaucoma (JOAG).MethodsThirty-three patients (46 eyes) were included in this single-center, retrospective, comparative study and treated with GATT (36 eyes) or KDB goniotomy (13 eyes). Intraocular pressure (IOP), number of glaucoma medications, adverse events, and additional anti-glaucoma procedures were collected during pre- and postoperative visits. Surgical success was defined as 6 mmHg ≤ IOP ≤ 18 mmHg and ≥ 20% IOP reduction from baseline with (partial success) or without (complete success) IOP-lowering medications.ResultsThe mean ± SD preoperative IOP was 30.48 ± 12.9 mmHg and 26.08 ± 13.1 mmHg (P = 0.164) on 3.71 ± 0.46 and 3.08 ± 0.86 (P = 0.023) glaucoma medications in GATT and KDB group, respectively. At 3 months, the mean ± SD IOP was 15.48 ± 5.93 mmHg and 20.0 ± 10.8 mmHg after GATT and KDB, respectively (P = 0.072). The percentage of IOP lowering from baseline was 44.4 in the GATT group and 14.1 in the KDB group (P = 0.011). The mean reduction in medications was 2.6 ± 1.7 and 0.8 ± 1.2 three months after GATT and KDB, respectively (P < 0.001). Cumulative proportion of partial and complete success were 65.6 and 44.7% in the GATT group, 30.8 and 15.4% in the KDB group at 6 months. Additional procedures were required in 13.9% of cases after GATT and in 61.5% after KDB (P = 0.001). Patients in the GATT group with prior anti-glaucoma procedures and postoperative IOP spikes were more likely to fail, while those with complete trabeculotomy had a better prognosis.ConclusionsReduction of IOP and medications were greater after GATT in uncontrolled JOAG eyes. Whereas, more additional IOP-lowering procedures were required after KDB goniotomy.Trial registrationThis study was registered under the Chinese Clinical Trial Registry ( ChiCTR2000034172 , 27/06/2020).

Project description:BackgroundTrabeculectomy (TRAB) traditionally has been the gold-standard surgical treatment for primary open-angle glaucoma (POAG), while gonioscopy-assisted transluminal trabeculotomy (GATT) is an emerging minimally invasive surgery used for the treatment of various open-angle glaucoma (OAG) types. In this study, we aimed to compare the efficacy and safety between GATT and TRAB for the treatment of POAG.MethodsThis cohort study included eyes with POAG that underwent a single GATT (30 eyes) or TRAB (34 eyes). Follow-up was conducted at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Intraocular pressure (IOP), the numbers of glaucoma medication, visual field mean deviation, peripapillary retinal nerve fiber layer thickness, surgical time, and complications were analyzed. Success criteria were defined as IOP ≤ 21 mmHg and ≥ 20% IOP reduction from baseline. Qualified and complete surgical success rates were also compared.ResultsIOP and antiglaucoma drug use decreased significantly at 12 months postoperatively in the both groups (P < 0.001), with no significant differences between the two groups pre- and postoperatively (P > 0.05). The success rates at 12 months were 70% (95% confidence interval [CI] = 52.6-87.4%) in the GATT group and 76.5% (95% CI = 61.4-91.5%) in the TRAB group (P = 0.559).Visual field loss remained unchanged at 12 months postoperatively compared with preoperative levels in both groups (P > 0.05); however, peripapillary retinal nerve fiber layer thickness decreased significantly at 12 months postoperatively compared with preoperative levels in the GATT group (P < 0.001). The most frequent complications after TRAB and GATT were bleb-related complications and hyphema, respectively.ConclusionsGATT demonstrated an efficacy comparable to that of TRAB for the treatment of POAG with regards to lowering IOP, reducing medication use, and preserving visual fields. Thus, GATT is a minimally invasive technique that enables an effective and safe decrease in IOP.

Dataset Information

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results.

Purpose

Methods

Results

Conclusions

Publications

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results.

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