Outcomes of gonioscopy-assisted 360-degree suture trabeculotomy in pseudoexfoliation glaucoma


Ozkul E., Tekcan H., Imamoglu S., Kugu S.

International Ophthalmology, vol.45, no.1, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 45 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1007/s10792-025-03813-x
  • Journal Name: International Ophthalmology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE
  • Keywords: GATT, Gonioscopy-assisted transluminal trabeculotomy, MIGS, Minimally invasive glaucoma surgery, Pseudoexfoliation glaucoma, Trabeculotomy
  • İstanbul Yeni Yüzyıl University Affiliated: Yes

Abstract

Purpose: To evaluate the outcomes of patients who underwent GATT. Patients and Methods: Thirty-one eyes of 31 patients undergoing GATT were investigated with a diagnosis of pseudoexfoliation glaucoma. Medical history, demographic data, diagnosis, intraocular pressure (IOP), anti-glaucomatous medications, cup/disc ratio, and retinal nerve fiber layer (RNFL) data were recorded. IOP measurements, complications, anti-glaucomatous medications, and a necessity for surgical interventions were documented postoperatively at various time points. Results: The average age was 67.6 years, while the average follow-up duration was 17.7 months. All cases exhibited pseudo-exfoliation (PEX). The initial IOP averaged 23.4 ± 7.8 mmHg, while the mean IOP at the final follow-up was 13.3 ± 2.9 mmHg. At baseline, the median number of active anti-glaucomatous medications was 3 (IQR:2), whereas, at the final follow-up, it decreased to 0 (IQR:1.75). Seventeen cases (54.8%) were deemed a complete success, while 11 cases (35.4%) were considered a partial success, and 3 cases (9.6%) failed. Conclusion: The distinctiveness of our study stems from implementing 360-degree trabeculotomy in all cases, a pioneering approach within the field. The study concluded that gonioscopy-assisted 360-degree suture trabeculotomy should be prioritized as the initial surgical option for patients with pseudoexfoliation glaucoma.