Evaluation of Peripheral Anterior Synechia Formation Following Gonioscopy Assisted Transluminal Trabeculotomy Surgery

Abstract

Abstract Purpose: To quantitatively assess the development of peripheral anterior synechia (PAS) formation rate and PAS locations on gonioscopic examination following gonioscopy-assisted transluminal trabeculotomy (GATT) surgery and investigate the surgical outcomes.Methods: A total of 35 eyes from 31 patients with open angle glaucoma who underwent GATT or combined GATT and phacoemulsification surgery as an initial glaucoma procedure were analyzed. Presence of PAS was assessed on gonioscopy in nasal, temporal, superior and inferior quadrants at months 1, 3 and 6 following surgery. Surgical outcomes were also noted.Results: The mean age of the patients was 68.8±9.2 years. The mean IOP and mean number of antiglaucoma medications decreased from 31.5±7.2 mmHg and 3.6±0.6 at baseline to 13.8±3.1 mmHg and 1.6±1.3 at postoperative 6 months, respectively (p<0.001, for both). Overall surgical success rate was found as 95.6% which was 30.4% without antiglaucoma medication. Mild to moderate degrees of hyphema occurred in all cases postoperatively. PAS formation rates were observed to be higher in nasal quadrant compared to temporal, superior and inferior quadrants on gonioscopy at months 1 (38.3%), 3 (34.0%) and 6 (32.3%) postoperatively. The highest amount of PAS involvement was 3 clock hours in the study which was identified only in nasal and inferior quadrants.Conclusion: PAS frequency was higher in nasal angle following GATT surgery. Broader PAS involvement was seen in both nasal and inferior angle regions.