A Prospective Comparison of 180 versus 360-Degree Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes in Pseudoexfoliation Glaucoma

Murat Gunay; Irem Berfu Cigiltepe; Adem Turk; Dilek Uzlu; Busra Kose

doi:10.1097/IJG.0000000000002391

A Prospective Comparison of 180 versus 360-Degree Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes in Pseudoexfoliation Glaucoma

J Glaucoma. 2024 Apr 9. doi: 10.1097/IJG.0000000000002391. Online ahead of print.

Authors

Murat Gunay¹, Irem Berfu Cigiltepe, Adem Turk, Dilek Uzlu, Busra Kose

Affiliation

¹ Karadeniz Technical University, Faculty of Medicine, Department of Ophthalmology, Trabzon, Turkey.

PMID: 38587449
DOI: 10.1097/IJG.0000000000002391

Abstract

Precis: Analysis of surgical success and intraocular pressure (IOP), best-corrected visual acuity (BCVA) and antiglaucomatous medication (AGM) changes between segmental 180-degree and 360-degree gonioscopy-assisted transluminal trabeculectomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG) showed no significant difference.

Purpose: To compare surgical outcomes of segmental 180-degree and 360-degree GATT in PEXG patients.

Materials and methods: Prospective, comparative study of 65 PEXG eyes, who underwent segmental 180-degree GATT (GATT 180° group, 31 eyes) and 360-degree GATT (GATT 360° group, 34 eyes) in a tertiary academic center over a 12-month of follow-up. Primary outcome was qualified and complete surgical success rates for Criterion A (IOP <18 mmHg and >30% reduction) and Criterion B (IOP <15 mmHg and >30% reduction). Secondary outcome measures included IOP reduction, BCVA change, AGM use and postoperative complications.

Results: The probabilites of qualified and complete success rates both for Criteria A and B did not significantly differ between the groups (P>0.05). IOP and BCVA levels were similar at each time point (P>0.05). IOP reduction was 59.3±9.5% in GATT 180° group and 55.8±18.1% in GATT 360° group (P=0.33). No significant difference in the mean number of AGM was present at the 12-month visit (1.2±1.1 in GATT 180° group vs 1.5±1.2 in GATT 360° group, P=0.25). Significantly higher incidences of postoperative hyphema and IOP spike were observed in GATT 360° group (P=0.01 and P=0.008, respectively).

Conclusion: Both segmental 180-degree and 360-degree GATT similarly reduced IOP and AGM with comparable surgical success rates in PEXG patients at the end of 12-months. Postoperative hyphema and IOP spike rate were siginificantly higher after 360-degree GATT. Segmental 180-degree GATT may be sufficient to adequately modulate IOP with lower incidence of postoperative complications in PEXG.