Risk Factors for Complications and Failure after Gonioscopy-Assisted Transluminal Trabeculotomy in a Young Cohort

Chen, Jenny; Wang, Ye Elaine; Quan, Ann; Grajewski, Alana L.; Hodapp, Elizabeth; Vanner, Elizabeth A.; Chang, Ta Chen

doi:10.1016/j.ogla.2020.02.002

Cited by 28 publications

(42 citation statements)

References 14 publications

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“…The exact causes of post-operative IOP spikes are unknown, though one proposed cause is corticosteroid-induced IOP elevation. 4,8 While our patients did receive steroid after surgery, this would not explain the low rate of IOP spikes (8%) and previous reports of high success rates for GATT in the treatment of steroid-induced glaucoma, even in patients requiring continued steroid use. 12 The rate of IOP spikes was 74% in our study, much higher than previously reported.…”

Section: Discussionmentioning

confidence: 72%

“…GATT is an increasingly popular procedure for patients with open angle glaucoma. 8,9,12 With its ability to create a circumferential opening of the trabecular meshwork and inner wall of Schlemm's canal, GATT is a logical choice in both PCG and JOAG, which are associated with angle anomalies, or goniodysgenesis. 13 Our group previously reported the high success rates of GATT in PCG, 14 however, much remains unknown regarding post-operative angle changes due to the difficulty of obtaining detailed examinations in young children.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Long-term outcomes regarding GATT outcomes in JOAG are not well-described, as most studies are retrospective, or JOAG patients were mixed with POAG patients or patients with secondary glaucoma. 5,6,[7][8][9] Early studies have identified several risk factors affecting success following GATT, including postoperative IOP spikes (defined as IOP >30 mmHg), 7,9 African-American race, 9 primary (as opposed to secondary) open angle glaucoma, 10 pseudophakia, 10 and noncircumferential trabeculotomy. 8 Prospective studies are needed to identify and address risk factors for post-procedure failures and complications.…”

mentioning

confidence: 99%

“…5,6,[7][8][9] Early studies have identified several risk factors affecting success following GATT, including postoperative IOP spikes (defined as IOP >30 mmHg), 7,9 African-American race, 9 primary (as opposed to secondary) open angle glaucoma, 10 pseudophakia, 10 and noncircumferential trabeculotomy. 8 Prospective studies are needed to identify and address risk factors for post-procedure failures and complications.…”

mentioning

confidence: 99%

“…In addition, early post-operative IOP spikes following GATT are of interest not only as a predictor of failure of GATT, but also because these may indicate a poor reserve in post-trabecular outflow system. 8 IOP spikes could be associated with greater visual morbidity in JOAG and require more aggressive management. This study aims to prospectively identify risk factors associated with early post-operative IOP spikes and failure following GATT with the goal of optimizing patient selection and post-operative care.…”

mentioning

confidence: 99%

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A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Shi

Wang

Oatts

et al. 2022

American Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Shi

Wang

Oatts

et al. 2022

American Journal of Ophthalmology

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Intraocular pressure spikes after gonioscopy-assisted transluminal trabeculotomy (GATT)

Naftali Ben Haim,

Yehezkeli,

Abergel Hollander

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

Goto,

Honjo,

Omoto

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose Minimally invasive glaucoma surgery is safer and effective surgical modality for patients with glaucoma. To compare the effect of axial length (AL) on the surgical outcomes of combined cataract surgery and ab interno trabeculotomy (phaco-LOT), a retrospective, non-randomized comparative study was performed. Methods In total, 458 eyes of 458 open-angle glaucoma patients who underwent phaco-LOT and were followed-up without any intervention for at least 6 months were enrolled. All were divided into a long-AL group (AL ≥ 26.0 mm, 123 eyes) and a not-long-AL group (AL < 26.0 mm, 335 eyes). The principal outcomes were the changes in intraocular pressure (IOP) and medication scores. We also sought a correlation between postoperative IOP spike and hyphema. Results Significant postoperative reductions in IOP and medication scores were apparent in all subjects. The IOP reductions were significant at all timepoints in the not-long-AL group, but not until 1 month postoperatively in the long-AL group, and the IOP change was significantly lower in the long-AL group from postoperative day 1 to 3 months. On subanalysis of subjects by age, the microhook used, the pre-operative IOP, and the medication score, a significantly higher incidence of IOP spike was observed in the long-AL group in weeks 1 and 2 (both p < 0.05), but this did not correlate with hyphema status, implying that a different mechanism was in play. Conclusion Phaco-LOT was effective regardless of AL, but the postoperative IOP decrease was lower and the early postoperative incidence of IOP spike was higher in long-AL eyes.

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Risk Factors for Complications and Failure after Gonioscopy-Assisted Transluminal Trabeculotomy in a Young Cohort

Cited by 28 publications

References 14 publications

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

A Prospective Study of Intraocular Pressure Spike and Failure After Gonioscopy-Assisted Transluminal Trabeculotomy in Juvenile Open-Angle Glaucoma

Intraocular pressure spikes after gonioscopy-assisted transluminal trabeculotomy (GATT)

The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

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