Gonioscopy-Assisted transluminal trabeculotomy: An ab interno circumferential trabeculotomy: 24 months follow-up

Davinder S. Grover, Oluwatosin Smith, Ronald L. Fellman, David G. Godfrey, Aditi Gupta, Ildamaris Montes De Oca, William J Feuer

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Abstract

Purpose: The purpose of this study was to provide 24-month followup on surgical success and safety of an ab interno circumferential 360-degree trabeculotomy. Methods: Chart review of patients who underwent a gonioscopyassisted transluminal trabeculotomy (GATT) procedure was performed by 4 of the authors (D.S.G., O.S., R.L.F., and D.G.G.). The surgery was performed in adults with various types of open-Angle glaucoma with preoperative intraocular pressures (IOPs) of ≥ 18mmHg. Results: In total, 198 patients aged 24 to 89 years underwent the GATT procedure with at least 18 months follow-up. Patients with primary open-Angle glaucoma had an average IOP decrease of 9.2mmHg at 24 months with an average decrease of 1.43 glaucoma medications. The mean percentage of IOP decrease in these primary open-Angle glaucoma groups at 24 months was 37.3%. In secondary open-Angle glaucoma, at 24 months there was an average decrease in IOP of 14.1mmHg on an average of 2.0 fewer medications. The mean percentage of IOP decrease in the secondary open-Angle glaucoma groups at 24 months was 49.8%. The cumulative proportion of failure at 24 months ranged from 0.18 to 0.48, depending on the group. In all 6 study groups, at all 5 postoperative time points (3, 6, 12, 18, and 24 mo) the mean IOP and reduction in glaucoma medications was significantly reduced from baseline (P< 0.001) with the exception of one time point. Conclusions: The 24-month results demonstrate that GATT is relatively safe and effective in treating various forms of open-Angle glaucoma. The long-Term results for GATT are relatively equivalent to those previously reported for GATT and ab externo trabeculotomy studies.

Original languageEnglish (US)
Pages (from-to)393-401
Number of pages9
JournalJournal of Glaucoma
Volume27
Issue number5
DOIs
StatePublished - Jan 1 2018

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Gonioscopy
Trabeculectomy
Intraocular Pressure
Open Angle Glaucoma
Glaucoma
Safety

Keywords

  • Ab interno
  • Circumferential trabeculotomy
  • GATT
  • Gonioscopy-Assisted transluminal trabeculotomy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Grover, D. S., Smith, O., Fellman, R. L., Godfrey, D. G., Gupta, A., De Oca, I. M., & Feuer, W. J. (2018). Gonioscopy-Assisted transluminal trabeculotomy: An ab interno circumferential trabeculotomy: 24 months follow-up. Journal of Glaucoma, 27(5), 393-401. https://doi.org/10.1097/IJG.0000000000000956

Gonioscopy-Assisted transluminal trabeculotomy : An ab interno circumferential trabeculotomy: 24 months follow-up. / Grover, Davinder S.; Smith, Oluwatosin; Fellman, Ronald L.; Godfrey, David G.; Gupta, Aditi; De Oca, Ildamaris Montes; Feuer, William J.

In: Journal of Glaucoma, Vol. 27, No. 5, 01.01.2018, p. 393-401.

Research output: Contribution to journalArticle

Grover, DS, Smith, O, Fellman, RL, Godfrey, DG, Gupta, A, De Oca, IM & Feuer, WJ 2018, 'Gonioscopy-Assisted transluminal trabeculotomy: An ab interno circumferential trabeculotomy: 24 months follow-up', Journal of Glaucoma, vol. 27, no. 5, pp. 393-401. https://doi.org/10.1097/IJG.0000000000000956
Grover, Davinder S. ; Smith, Oluwatosin ; Fellman, Ronald L. ; Godfrey, David G. ; Gupta, Aditi ; De Oca, Ildamaris Montes ; Feuer, William J. / Gonioscopy-Assisted transluminal trabeculotomy : An ab interno circumferential trabeculotomy: 24 months follow-up. In: Journal of Glaucoma. 2018 ; Vol. 27, No. 5. pp. 393-401.
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abstract = "Purpose: The purpose of this study was to provide 24-month followup on surgical success and safety of an ab interno circumferential 360-degree trabeculotomy. Methods: Chart review of patients who underwent a gonioscopyassisted transluminal trabeculotomy (GATT) procedure was performed by 4 of the authors (D.S.G., O.S., R.L.F., and D.G.G.). The surgery was performed in adults with various types of open-Angle glaucoma with preoperative intraocular pressures (IOPs) of ≥ 18mmHg. Results: In total, 198 patients aged 24 to 89 years underwent the GATT procedure with at least 18 months follow-up. Patients with primary open-Angle glaucoma had an average IOP decrease of 9.2mmHg at 24 months with an average decrease of 1.43 glaucoma medications. The mean percentage of IOP decrease in these primary open-Angle glaucoma groups at 24 months was 37.3{\%}. In secondary open-Angle glaucoma, at 24 months there was an average decrease in IOP of 14.1mmHg on an average of 2.0 fewer medications. The mean percentage of IOP decrease in the secondary open-Angle glaucoma groups at 24 months was 49.8{\%}. The cumulative proportion of failure at 24 months ranged from 0.18 to 0.48, depending on the group. In all 6 study groups, at all 5 postoperative time points (3, 6, 12, 18, and 24 mo) the mean IOP and reduction in glaucoma medications was significantly reduced from baseline (P< 0.001) with the exception of one time point. Conclusions: The 24-month results demonstrate that GATT is relatively safe and effective in treating various forms of open-Angle glaucoma. The long-Term results for GATT are relatively equivalent to those previously reported for GATT and ab externo trabeculotomy studies.",
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