Gonioscopy-assisted transluminal trabeculotomy reduces IOP in juvenile glaucoma

A novel ab interno trabeculotomy method reduced IOP and postoperative medication load in the treatment of primary congenital glaucoma and juvenile open-angle glaucoma, according to a study.

Gonioscopy-assisted transluminal trabeculotomy (GATT) is a 360° ab interno conjunctival-sparing technique performed through a 23-gauge needle paracentesis track located tangentially in the superonasal or inferonasal quadrant.

The retrospective chart review included 14 eyes of 10 patients with a dysgenic anterior segment angle and uncontrolled primary congenital glaucoma or juvenile open-angle glaucoma who underwent GATT. Mean patient age was 18.4 years (range: 17 months to 30 years). Mean follow-up was 20.4 months (range: 12 months to 33 months).

Mean IOP decreased from 27.3 mm Hg to 14.8 mm Hg. IOP decreased 15 mm Hg or more in five eyes.

Mean number of glaucoma medications decreased from 2.6 to 0.86.

No intraoperative or postoperative complications were reported.

A 360° trabeculotomy was achieved in all eyes except one eye in which only 180° of the angle could be treated because of the extent of angle dysgenesis. The eye underwent implantation of a glaucoma drainage tube. The patient underwent subsequent GATT on the fellow eye. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Grover DS, et al. Br J Ophthalmol. 2015;doi:10.1136/bjophthalmol-2014-306269.