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Surgical Outcomes of Gonioscopy-assisted Transluminal Trabeculotomy (GATT) in Patients With Open-angle Glaucoma

Rahmatnejad, Kamran MD*; Pruzan, Noelle L. MD*; Amanullah, Sarah BA†,‡; Shaukat, Bilal A. BS*; Resende, Arthur F. MD*; Waisbourd, Michael MD*; Zhan, Tingting PhD; Moster, Marlene R. MD*

doi: 10.1097/IJG.0000000000000802
Original Studies

Purpose: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open-angle glaucoma.

Participants and Methods: A retrospective chart review of adult patients who underwent GATT due to inadequately controlled intraocular pressure (IOP) or intolerance to medication. Main outcome measures were success rate, IOP, and number of glaucoma medications. Success was defined as IOP reduction >20% from baseline or IOP between 5 to 21 mm Hg, and no need for further glaucoma surgery. When success criteria were not met for any postoperative visit >3 months after surgery, failure was determined.

Results: In total, 66 patients, average age 62.9±14.9 years (50.8% female) were included in the analysis. Average follow-up was 11.9 months (range, 3 to 30 mo) and overall success rate was 63.0%. Mean IOP was 26.1±9.9 mm Hg preoperatively and 14.6±4.7 mm Hg at 12 months (44% IOP decrease; P<0.001). Mean number of medications decreased from 3.1±1.1 preoperatively to 1.2±0.9 at 12 months (P<0.001). No significant differences between patients with primary open-angle glaucoma and other types of glaucoma were found.

The rate of hyphema at 1 week and 1 month postoperatively was 38% and 6%, respectively. Overall GATT success rate among white and black patients was 69% and 42%, respectively, which was statistically significant (P<0.05).

Conclusions: The future of GATT as a minimally invasive glaucoma surgery in adults seems promising. This position is supported by its low rate of long-term complications and the conjunctiva-sparing nature of the surgery.

*Wills Eye Hospital, Glaucoma Research Center

Sidney Kimmel Medical College

Department of Biostatistics, Thomas Jefferson University, Philadelphia, PA

ORCID: 0000-0002-4071-0408.

Presented in part at the American Glaucoma Society Annual Meeting, March 2017, San Diego, CA.

Disclosure: The authors declare no conflict of interest.

Reprints: Kamran Rahmatnejad, MD, Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Suite 1140, Philadelphia, PA 19107 (e-mail: krahmatnejad@gmail.com).

Received June 5, 2017

Accepted September 23, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.