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Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Postpenetrating Keratoplasty Steroid-induced Glaucoma

A Case Report

Nazarali, Samir BHSc*; Cote, Stephanie L. MD; Gooi, Patrick MD, FRCSC

doi: 10.1097/IJG.0000000000001034
Online Articles: Case Report/Small Case Series

Glaucoma following penetrating keratoplasty (PKP) remains the leading cause of blindness following PKP. Patients with post-PKP glaucoma can be managed medically and surgically. Evidence studying glaucoma surgical techniques following PKP is limited, but suggests the possibility for high-risk complications, including graft failure. Minimally invasive glaucoma surgeries offer an alternative. We report the first case of post-PKP glaucoma managed with gonioscopy-assisted transluminal trabeculotomy (GATT). The patient was a 33-year-old man with a history of keratoconus who underwent PKP in his right eye. On presentation, his visual acuity was 20/60 and intraocular pressure was 48 mm Hg OD. He underwent GATT and cataract phacoemulsification. Following 22 months of follow-up, the patient’s visual acuity was 20/30 and intraocular pressure 13 mm Hg, off all glaucoma medications. This case demonstrates GATT may be a good surgical option for post-PKP glaucoma, given the ability to perform future incisional surgery and avoidance of high-risk complications associated with traditional glaucoma surgeries.

*Faculty of Medicine, University of Ottawa, Ottawa

Department of Ophthalmology, University of Western Ontario, London, ON

Division of Ophthalmology, University of Calgary, Calgary, AB, Canada

Disclosure: The authors declare no conflict of interest.

Reprints: Patrick Gooi, MD, FRCSC, Cloudbreak Eye Care, 5340 1 St SW #315, Calgary, AB, Canada T2H 0C8. (e-mail:

Received June 5, 2018

Accepted July 18, 2018

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