Efficacy and Safety of Gonioscopy-Assisted Transluminal Trabeculotomy for Primary Congenital Glaucoma

Abstract

Précis: Gonioscopy-assisted transluminal trabeculotomy (GATT) provided effective intraocular pressure (IOP) control in primary congenital glaucoma (PCG). Also, approximately two third of patients did not need antiglaucoma medication at an average follow-up of 1 year after surgery. Purpose: The purpose of this study was to assess the safety and efficacy of GATT surgery in eyes with PCG. Materials and Methods: This study is a retrospective review of patients who underwent GATT surgery for PCG. Outcome measures were changes in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), and success rates. Success was defined as IOP<21 mm Hg with at least a 30% reduction from the baseline, complete if without medications, or qualified if with or without medications. Cumulative success probabilities were analyzed using the Kaplan-Meier survival analyses. Results: Twenty-two eyes of 14 patients diagnosed with PCG were enrolled in this study. The mean IOP reduction was 13.1 mm Hg (57.7%) with a mean decrease of 2 glaucoma medications at the final follow-up. All mean IOP readings during postoperative follow-up were significantly lower than baseline (P<0.05 for all). Cumulative probability of qualified success was 95.5% and the cumulative probability of complete success was 66.7%. Conclusion: GATT was safe and successfully lowered IOP in patients with PCG with the advantage of avoiding conjunctival and scleral incisions.