Prolene suture gonioscopy-assisted transluminal trabeculotomy safe and effective treatment of glaucoma: Study
Researchers found that prolene suture gonioscopy-assisted transluminal trabeculotomy (GATT) is efficient in reducing intraocular pressure (IOP) and diminishing the long-term usage of glaucoma medication. A recent study was published in the Journal of Glaucoma conducted by Zhang and colleagues.
The objective of the study was to evaluate the long-term effectiveness of prolene suture GATT in reducing IOP, and in minimizing the use of glaucoma medications, while identifying the risk factors for surgical outcomes. This was a retrospective cohort study of adult patients undergoing prolene suture GATT by a single surgeon at a medical center. Data from 145 eyes of 124 patients were analyzed concerning changes in intraocular pressure, use of glaucoma medications, and rates of reoperation up to four years of follow-up.
The study showed a marked reduction of IOP from a preoperative level of 22.1±7.8 mm Hg to 15.1±3.2 mm Hg at three years and 15.1±3.5 mm Hg at four years after the surgery.
The number of medications for glaucoma was also reduced. It came down to 1.3 ± 1.4 at three years and 1.4 ± 1.5 at four years post surgery from the baseline of 3.2 ± 1.1 preoperatively. What was impressive was that 44% of the eyes were totally medication-free at year four.
Those who had GATT alone tended to have a higher revision rate of 31% compared with those who had GATT/CE combined.
Patients with prior trabeculoplasty had worse outcomes with a higher reoperation rate at 28.8% compared to those without trabeculoplasty, which stood at 16.1%.
Kaplan–Meier survival analysis of combined GATT/CE surgery not combined with trabeculoplasty achieved the best outcome, with a median time to failure of 48 months.
Contrastively, eyes that received GATT and previous trabeculoplasty exhibited a relatively short median time to failure of only 18 months. Eyes that had GATT alone, with or without prior trabeculoplasty, exhibited median times to failure of 9 and 12 months, respectively.
Prolene suture GATT effectively lowers intraocular pressure and reduces the use of medication for glaucoma during long-term follow-up, with many patients remaining medication-free years after surgery. These findings suggest that GATT is indeed a good option for the treatment of glaucoma.
Reference:
Zhang, X., Chow, A., & Chen, E. (2024). Surgery outcomes of prolene suture gonioscopy-assisted transluminal trabeculotomy (GATT): Up to 4 years follow-up and prognostic factors. Journal of Glaucoma, 33(9), 645–651. https://doi.org/10.1097/ijg.0000000000002417
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