Gonioscopy-assisted transluminal trabeculotomy is an effective surgical treatment for uveitic glaucoma

Avner Belkin*, Yuri Valere Chaban, Derek Waldner, Saba Samet, Iqbal Ike K. Ahmed, Patrick Gooi, Matthew B. Schlenker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)690-697
Number of pages8
JournalBritish Journal of Ophthalmology
Volume107
Issue number5
DOIs
StatePublished - May 2023

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