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Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma

PURPOSE: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. METHODS: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical suc...

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Autores principales: Dar, Nimrod, Naftali Ben Haim, Liron, Yehezkeli, Veronika, Sharon, Tal, Belkin, Avner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538851/
https://www.ncbi.nlm.nih.gov/pubmed/37530276
http://dx.doi.org/10.4103/IJO.IJO_2769_22
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author Dar, Nimrod
Naftali Ben Haim, Liron
Yehezkeli, Veronika
Sharon, Tal
Belkin, Avner
author_facet Dar, Nimrod
Naftali Ben Haim, Liron
Yehezkeli, Veronika
Sharon, Tal
Belkin, Avner
author_sort Dar, Nimrod
collection PubMed
description PURPOSE: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. METHODS: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical success; intra-ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ≤ of baseline on fewer medications as compared to baseline. RESULTS: Forty-seven eyes were included in the analysis. The average mean deviation was -17.5 ± 7.2 dB (range −8.0 to -33.0). The average follow-up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6(th) post-operative month (P < 0.001 for both IOP and medications). At the last follow-up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery. CONCLUSIONS: GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post-operative management are imperative.
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spelling pubmed-105388512023-09-29 Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma Dar, Nimrod Naftali Ben Haim, Liron Yehezkeli, Veronika Sharon, Tal Belkin, Avner Indian J Ophthalmol Original Article PURPOSE: To evaluate the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. METHODS: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single-center chart review. The main outcome measure was surgical success; intra-ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ≤ of baseline on fewer medications as compared to baseline. RESULTS: Forty-seven eyes were included in the analysis. The average mean deviation was -17.5 ± 7.2 dB (range −8.0 to -33.0). The average follow-up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6(th) post-operative month (P < 0.001 for both IOP and medications). At the last follow-up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery. CONCLUSIONS: GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post-operative management are imperative. Wolters Kluwer - Medknow 2023-08 2023-08-01 /pmc/articles/PMC10538851/ /pubmed/37530276 http://dx.doi.org/10.4103/IJO.IJO_2769_22 Text en Copyright: © 2023 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Dar, Nimrod
Naftali Ben Haim, Liron
Yehezkeli, Veronika
Sharon, Tal
Belkin, Avner
Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title_full Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title_fullStr Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title_full_unstemmed Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title_short Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
title_sort gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538851/
https://www.ncbi.nlm.nih.gov/pubmed/37530276
http://dx.doi.org/10.4103/IJO.IJO_2769_22
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