The Efficacy and Safety of the GATT Procedure in Open-Angle Glaucoma—6-Month Results

Abstract

AIM. The aim of the study was to retrospectively evaluate the efficacy and safety of GATT during a 6-month observation period. MATERIAL AND METHODS. The studied group consisted of 69 open-angle glaucoma patients treated with GATT as the only procedure or in combination with cataract surgery. Patients were assessed 1 day, 10 days, 1 month, 3 months, and 6 months after the surgery via standard ophthalmic examination including VF, IOP, and BCVA. The number of medications taken daily and possible complications were checked. Two criteria of success were established (S1: IOP decrease by 30% and S2: IOP lower than 18 mm Hg). RESULTS. Before the surgery, the mean IOP was 26.94 mmHg and significantly decreased after GATT to 15.59 mmHg at 6M. BCVA did not significantly differ between the visits. The mean MD did not change significantly within the 6-month observation period (−8.20 dB vs. −8.16 dB, p = 0.9824), similar to the mean VFI (64.31% vs. 63.05%, p = 0.8571). A 30% IOP decrease at 6M visit was obtained in 95.6% of patients, and 37.7% needed medications to stabilize IOP. An IOP lower than 18 mmHg at 6M was obtained in 91.3% of studied patients after the GATT procedure, and in 58.0% without additional medications. The mean number of medications received daily decreased significantly at 6M compared to preoperative results (2.59 at inclusion vs. 0.76 at 6M, p = 0.0004). The most frequent complication after surgery was hyphema, which resolved spontaneously within 10 days. CONCLUSION. The 6-month observation showed that GATT is a minimally invasive glaucoma-surgery technique that enables an effective and safe IOP decrease.

Reflux hyphema from transient hypotony after Ozurdex® in eyes with prior GATT

“…The rate of hyphema after GATT has been reported to be 51 % at POD1, 16–30 % at POW1, and 1–6% at POM1. 5 , 6 Delayed-onset reflux hyphemas have been reported in eyes with prior angle surgery in the absence of trauma. 2 , 3 , 7 Ahuja et al reported a series of 12 patients with symptomatic hyphema 2–31 months after Trabectome® (NeoMedix Corp., Tustin, CA) surgery, wherein most patients reported preceding physical exertion or sleeping on the operative side.…”

Minimally Invasive Glaucoma Surgery: A Review of the Literature

“…Studies have demonstrated significant IOP reduction and reduced reliance on anti-glaucoma medications following GATT, with a favorable safety profile and minimal adverse events such as transient hyphema and IOP spikes [ 53 , 54 ]. While GATT is effective and adaptable, it carries unique complications such as an increased risk of hyphema from the extensive unroofing of Schlemm’s canal [ 55 ]. Typically, these transient events resolve spontaneously or with conservative management, and postoperative IOP spikes are generally well controlled with medication.…”