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Outcomes of gonioscopy-assisted transluminal trabeculotomy in advanced pigmentary glaucoma
British Journal of Ophthalmology ( IF 3.7 ) Pub Date : 2024-09-24 , DOI: 10.1136/bjo-2024-325749
Arnav Panigrahi, Anurag Kumar, Shikha Gupta, Davinder S Grover, Viney Gupta

Purpose To compare outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) over a 12-month period with trabeculectomy in patients with advanced pigmentary glaucoma (PG). Methods This was a pilot randomised controlled trial of patients with advanced PG (mean deviation worse than −12 dB), undergoing either GATT or a fornix-based trabeculectomy. Absolute success (criterion A) was defined as a postoperative intraocular pressure (IOP) between 6 and 18 mm Hg, with a drop of at least 30% from the treated preoperative value without need of any IOP-lowering medication. Success (criterion B) was also defined as per the target IOP, with an upper limit of 15 mm Hg for eyes with mean deviation (MD) between −12 and −24 dB, and 12 mm Hg or lower for MD values worse than −24 dB. Qualified success was a similar IOP standard on the same or fewer antiglaucoma medications. Results For GATT (n=10), mean preoperative IOP and number of glaucoma medications were 28.2±11.2 mm Hg and 4±0.8 that reduced to 11.8±2.5 mm Hg and 0.7 at 12 months postoperatively, while in the trabeculectomy (n=12) group, they were 27.3±5.5 mm Hg and 3.6±0.7 that reduced to 11.5±2.2 mm Hg and 0.5±0.9, respectively. All eyes (100%) achieved qualified success. Absolute success was 60% and 67.7% by criterion A and 50% and 58.3% by criterion B for GATT and trabeculectomy, respectively. Two eyes in the trabeculectomy group developed hypotony while none of the GATT group had any sight-threatening complications (p=0.4). Conclusions GATT alone demonstrated a significant reduction in IOP and number of glaucoma medications in patients with advanced PG. Data are available upon reasonable request. Not Applicable.

中文翻译:


房角镜辅助经腔小梁切开术治疗晚期色素性青光眼的结果



目的 比较晚期色素性青光眼 (PG) 患者 12 个月内房角镜辅助腔内小梁切开术 (GATT) 与小梁切除术的结果。方法 这是一项针对接受 GATT 或基于穹窿的小梁切除术的晚期 PG(平均偏差低于 -12 dB)患者的随机对照试验。绝对成功(标准 A)定义为术后眼压 (IOP) 在 6 至 18 mm Hg 之间,较术前治疗值下降至少 30%,且无需任何降 IOP 药物。成功(标准 B)也根据目标 IOP 进行定义,平均偏差 (MD) 在 -12 至 -24 dB 之间的眼睛的上限为 15 毫米汞柱,对于 MD 值低于 - 的眼睛,上限为 12 毫米汞柱或更低。 24分贝。合格的成功是使用相同或更少的抗青光眼药物达到类似的眼压标准。结果 对于 GATT (n=10),术前平均眼压和青光眼药物数量分别为 28.2±11.2 mm Hg 和 4±0.8,术后 12 个月降至 11.8±2.5 mm Hg 和 0.7,而在小梁切除术中 (n=12) )组,分别为27.3±5.5 mm Hg和3.6±0.7,降至11.5±2.2 mm Hg和0.5±0.9。所有眼睛(100%)都取得了合格的成功。根据标准 A,GATT 和小梁切除术的绝对成功率分别为 60% 和 67.7%,根据标准 B 分别为 50% 和 58.3%。小梁切除术组中的两只眼睛出现眼压过低,而 GATT 组中没有一只眼睛出现任何威胁视力的并发症 (p=0.4)。结论 单独使用 GATT 可以显着降低晚期 PG 患者的眼压和青光眼药物数量。数据可根据合理要求提供。不适用。
更新日期:2024-09-25
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