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：

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房角镜辅助腔内小梁切开术治疗晚期色素性青光眼的结局


目的 比较晚期色素性青光眼 （PG） 患者房角镜辅助腔内小梁切开术 （GATT） 在 12 个月内与小梁切除术的结果。方法 这是一项针对晚期 PG （平均偏差小于 -12 dB） 患者接受 GATT 或基于穹窿的小梁切除术的随机对照试验。绝对成功（标准 A）定义为术后眼压 （IOP） 在 6 至 18 毫米汞柱之间，从治疗前值下降至少 30%，无需任何降眼压药物。成功（标准 B）也根据目标眼压定义，平均偏差 （MD） 在 -12 和 -24 dB 之间的眼睛上限为 15 毫米汞柱，MD 值低于 -24 dB 的眼睛上限为 12 毫米汞柱或更低。合格的成功是在相同或更少的抗青光眼药物上达到相似的 IOP 标准。结果 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，而小梁切除术 （n=12） 组分别为 27.3±5.5 mm Hg 和 3.6±0.7，分别降至 11.5±2.2 mm Hg 和 0.5±0.9， 分别。All eyes （100%） 取得了合格的成功。GATT 和小梁切除术的绝对成功率分别为标准 A 的 60% 和 67.7%，标准 B 的绝对成功率分别为 50% 和 58.3%。小梁切除术组的两只眼出现低渗，而 GATT 组没有出现任何威胁视力的并发症 （p=0.4）。结论 单独的 GATT 显示晚期 PG 患者的 IOP 和青光眼药物数量显著降低。不適用。