Grover Davinder S, Godfrey David G, Smith Oluwatosin, Shi Wei, Feuer William J, Fellman Ronald L
*Glaucoma Associates of Texas, Dallas, TX †Bascom Palmer Eye Institute, University of Miami, Miami, FL.
J Glaucoma. 2017 Jan;26(1):41-45. doi: 10.1097/IJG.0000000000000564.
To report on outcomes of gonioscopy-assisted transluminal trabeculotomy (GATT) in eyes with prior incisional glaucoma surgery.
A retrospective review was performed for all patients who underwent a GATT procedure with a history of prior incisional glaucoma surgery.
Thirty-five eyes of 35 patients were treated. The mean age was 67.7 years. Nineteen eyes had a prior trabeculectomy, 13 eyes had a prior glaucoma drainage device, 4 eyes had a prior trabectome, and 5 eyes had prior endocyclophotocoagulation. Mean follow-up time was 22.7 months. For all eyes, the mean preoperative intraocular pressure (IOP) (SD) was 25.7 (6.5) mm Hg on 3.2 (1.0) glaucoma medications and at 24 months, the mean IOP (SD) was 15.4 (4.9) mm Hg on 2.0 (1.4) glaucoma medications (P<0.001). The prior trabeculectomy group had a preoperative IOP (SD) of 24.6 (6.4) mm Hg on 3.2 (1.0) medications and at month 24, the mean IOP (SD) was 16.7 (5.6) mm Hg on 2.1 (1.4) glaucoma medications. In the prior glaucoma drainage device group, the mean preoperative IOP (SD) was 27.0 (7.1) mm Hg on 3.4 (1.1) glaucoma medications and at 24 months, the mean IOP (SD) was 12.9 (2.6) mm Hg on 2.1 (1.2) glaucoma medications. At 24 months, the cumulative proportion of failure was 0.4 and the cumulative proportion of reoperation was 0.29.
GATT appears to be safe and successful in treating 60% to 70% of open-angle patients with prior incisional glaucoma surgery. When considering all eyes, there was a significant decrease in IOP and required glaucoma medications at 24 months. This surgery should be considered in certain patients with open angles who have failed a primary traditional glaucoma surgery.
报告前房角镜辅助小梁切开术（GATT）治疗既往接受过青光眼切开手术的患者的疗效。
对所有既往有青光眼切开手术史且接受GATT手术的患者进行回顾性研究。
共治疗35例患者的35只眼。平均年龄67.7岁。19只眼曾行小梁切除术，13只眼曾植入青光眼引流装置，4只眼曾行小梁消融术，5只眼曾行眼内激光光凝术。平均随访时间22.7个月。所有患眼术前平均眼压（标准差）为25.7（6.5）mmHg，使用3.2（1.0）种青光眼药物；24个月时，平均眼压（标准差）为15.4（4.9）mmHg，使用2.0（1.4）种青光眼药物（P<0.001）。既往小梁切除术组术前眼压（标准差）为24.6（6.4）mmHg，使用3.2（1.0）种药物；24个月时，平均眼压（标准差）为16.7（5.6）mmHg，使用2.1（1.4）种青光眼药物。既往青光眼引流装置植入组术前平均眼压（标准差）为27.0（7.1）mmHg，使用3.4（1.1）种青光眼药物；24个月时，平均眼压（标准差）为12.9（2.6）mmHg，使用2.1（1.2）种青光眼药物。24个月时，失败的累积比例为0.4，再次手术的累积比例为0.29。
GATT治疗既往接受过青光眼切开手术的开角型青光眼患者，60%至70%的患者似乎安全且有效。综合所有患眼来看，24个月时眼压和所需青光眼药物显著减少。对于原发性传统青光眼手术失败的某些开角型患者，应考虑行此手术。
