2Assoc Prof, Haydarpasa Numune Training and Research Hospital, İstanbul, Türkiye DOI : 10.37844/TJ-CEO.2024.1.4 Purpose: To compare the outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy in pseudophakic eyes with pseudoexfoliative glaucoma (PXG).
Materials and Methods: This retrospective case-series included a total of 36 pseudophakic eyes with PXG, 17 in the GATT group and 19 in the trabeculectomy group. The outcome measures were changes in intraocular pressure (IOP), number of glaucoma medications used, visual acuity changes, success rate (IOP reduction ?20% from the baseline or IOP between 6 and 21 mmHg, without further glaucoma surgery), complications, and revisional procedures. Kaplan-Meier survival analyses were performed for estimated survival time and compared.
Results: According to the final visit evaluations, the mean IOP decreased by 13.47 mmHg (52.1%) in the GATT group and by 16.69 mmHg (56.4%) in the trabeculectomy group. The mean IOP reduction did not significantly differ between the GATT and trabeculectomy groups (p>0.05). The number of failed eyes was 4 (23.5%) in the GATT group and 5 (26.3%) in the trabeculectomy group (p>0.05). The estimated failure times were 18.02±2.57 months for the GATT group and 37.92±7.79 months for the trabeculectomy group (p>0.05). In both groups, the number of glaucoma medications decreased significantly (p = 0.002 for the GATT group, p = 0.01 for the trabeculectomy group).The median time to first glaucoma medication use after surgery was 1.0 (0.5) month for the GATT group and 3.0 (11.0) months for the trabeculectomy group (p=0.001).
Conclusion: Both GATT and trabeculectomy effectively reduced the IOP and medication burden in pseudophakic eyes with PXG.
Keywords : Trabeculectomy, gonioscopy-assisted transluminal trabeculotomy, intraocular pressure, pseudoexfoliative glaucoma, pseudophakia