Gonioscopy-Assisted Transluminal Trabeculotomy: A Review

Aboalazayem, Fayrouz; Elhusseiny, Abdelrahman M.; Sayed, Yasmine M. El

doi:10.1080/02713683.2022.2084113

Cited by 4 publications

(5 citation statements)

References 72 publications

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“…Complete success rate was 66.67%, qualified success rate was 26.67% and 6.66% of unsuccessful cases required reoperation. The EVFW grade of complete success patients was 3.4±0.6 (3)(4), and that of qualified success patients was 2.6±1.0 (2-4) and there was a statistical difference between them (P<0.05; Table 2).…”

Section: Subjects and Mathods Ethical Approvalmentioning

confidence: 90%

“…This procedure provides a physiological pathway for a smoother outflow [2][3] . Gonioscopy-assisted transluminal trabeculotomy (GATT) is one of MIGS surgeries [4] . The theory of GATT is to cut the trabecular tissue and the inner wall of Schlemm's canal in a 360-degree circular way with suture or catheter assisted by gonioscope, so that the aqueous humor can directly connect with the Schlemm's canal, so as to reduce the resistance of aqueous humor outflow and achieve the purpose of lowering intraocular pressure (IOP) [5][6] .…”

Section: Introductionmentioning

confidence: 99%

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Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

Zeng,

Wang,

Xian

et al. 2023

Int J Ophthalmol

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AIM: To evaluate the clinical significance of checking episcleral venous fluid wave (EVFW) during gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open angle glaucoma (OAG). METHODS: This retrospective case series study comprised 30 patients (45 eyes) with OAG underwent GATT. The location and extent of EVFW were examined and graded after intraoperative compression flushing of the anterior chamber angle during the operation. Patients were followed up for 1y. A complete success for surgery is defined as a postoperative intraocular pressure (IOP) <18 mm Hg without any anti-glaucoma medication. IOP<18 mm Hg with less than two anti-glaucoma medications is defined as qualified success, while the control of IOP requiring three anti-glaucoma medications is considered as unsuccess. RESULTS: The mean IOP was 35.38±7.16 mm Hg before surgery and 15.52±4.22 mm Hg 1y after surgery (P<0.01). The average number of anti-glaucoma medication was 2.8±1.2 (2-4) preoperation and 0.6±1.3 (0-3) 1y postoperation (P<0.01). The success rate of the operation was 93.33%. Complete success rate was 66.67%, qualified success rate was 26.67%, and 6.66% of unsuccessful cases required reoperation. EVFW of all cases was grade 2-4, and the percentages of grade 2, 3 and 4 were 33.33%, 40.0% and 26.67%, respectively. The distribution and percentage of EVFW were inferior (36%), nasal (28%), superior (20%), and temporal (16%). The EVFW grade of complete success patients was 3.4±0.6 (3-4), and that of qualified success patients was 2.6±1.0 (2-4). The larger the range of EVFW, the lower the IOP, and the better the IOP reduction effect. CONCLUSION: During GATT surgery, pressurized irrigation of anterior chamber to check EVFW can reduce the outflow resistance of aqueous humor and increase the effect of postoperative IOP. The range of EVFW is negatively correlated with postoperative IOP. Therefore, EVFW may be a valuable prognostic indicator for the success of GATT surgery.

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Section: Subjects and Mathods Ethical Approvalmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

Zeng,

Wang,

Xian

et al. 2023

Int J Ophthalmol

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“…GATT has been shown to be a versatile and effective option for managing mild to moderate open-angle glaucoma, including primary OAG, juvenile OAG, and pseudoexfoliative glaucoma [ 52 ]. The procedure can be performed as a standalone intervention or combined with cataract surgery, allowing for a more comprehensive and individualized treatment strategy.…”

Section: Devices Procedures and Surgical Techniquesmentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery: A Review of the Literature

Balas,

Mathew

2023

Vision

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Minimally invasive glaucoma surgery (MIGS) has emerged as a novel approach in the glaucoma treatment spectrum, offering a range of diverse procedures and devices aimed at reducing intraocular pressure (IOP). MIGS can be broadly classified into several categories: those that enhance trabecular outflow (Trabectome, iStent, Hydrus Microstent, Kahook Dual Blade, high frequency deep sclerotomy, and gonioscopy-assisted transluminal trabeculotomy), those that augment suprachoroidal outflow (CyPass Microstent and iStent Supra), those that target Schlemm’s canal (TRAB360 and the OMNI Surgical System, Streamline, and Ab Interno Canaloplasty), and conjunctival bleb-forming procedures (EX-PRESS Glaucoma Filtration Device, Xen Gel Stent and PreserFlo MicroShunt). MIGS is considered to have a shorter surgical time and fewer severe complications when compared to traditional glaucoma surgeries such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves). This literature review comprehensively examines the distinct MIGS devices and procedures, their underlying mechanisms, and clinical outcomes, emphasizing the importance of evaluating the efficacy and complications of each approach individually. As the field of MIGS continues to evolve, it is crucial to prioritize high-quality, long-term studies to better understand the safety and effectiveness of these innovative interventions in glaucoma management.

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“…It allows the cannulation of Schlemm's canal (SC) using a suture or microcatheter through a corneal incision [5,6]. There has been growing evidence in the literature supporting its efficacy in adult glaucoma; however, few studies have evaluated its efficacy in PCG [6][7][8][9][10]. The pur-pose of this study is to evaluate the efficacy and outcomes of GATT in a PCG cohort who underwent previous glaucoma surgeries.…”

Section: Introductionmentioning

confidence: 99%

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results

Elhusseiny

Aboulhassan

Sayed

et al. 2023

Case Reports in Ophthalmological Medicine

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Purpose. To evaluate the one-year outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in primary congenital glaucoma (PCG) with a history of prior glaucoma surgery. Methods. A retrospective chart review was performed to identify all PCG patients ≤ 16 years who underwent GATT surgery at Cairo University Children’s Hospital from January 2016 to March 2022. Pre- and postoperative intraocular pressure (IOP) and glaucoma medications were collected at 1, 3, 6, 9, 12, and last follow-up visits. Success was defined as IOP ≤ 21 mmHg without (complete) or with (qualified) glaucoma medications at the last follow-up. Results. Seven eyes of 6 subjects were included in the study. The mean IOP was statistically significantly reduced from 25.7 ± 5.9 mmHg preoperatively to a mean IOP of 12 ± 1.5 mmHg ( P = 0.001 ) at 12 months and 11.5 ± 1.2 mmHg ( P = 0.001 ) at the last follow-up visit. Six eyes (85.7%) achieved complete success, and one eye (14.2%) achieved qualified success. No patients required further glaucoma procedures. No serious intra- or postoperative complications were identified. Conclusions. Our early experience highlights that GATT can be performed as an alternative procedure before considering conjunctival or scleral glaucoma surgeries.

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Gonioscopy-Assisted Transluminal Trabeculotomy: A Review

Cited by 4 publications

References 72 publications

Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

Minimally Invasive Glaucoma Surgery: A Review of the Literature

Gonioscopy-Assisted Transluminal Trabeculotomy following Failed Glaucoma Surgery in Primary Congenital Glaucoma: One-Year Results

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